Abstract
This research was conducted to determine the genetic basis of resistance against antibiotics in Helicobacter pylori which is a major cause of chronic gastritis and peptic ulcer. The detection of genetic determinants involved in resistance; a reference-based approach was applied with high-throughput next-generation sequencing (NGS). The sample size was 105 and H. pylori strains were isolated from the culture and tested for antibiotic susceptibility. NGS data was used for genotypic analysis. We assessed the statistical relationships between resistance genotypes and phenotypes. 69% of the bacteria were resistant to metronidazole, 21.2% to levofloxacin, 38% to clarithromycin, and 12.9% to amoxicillin, according to our findings. There was no evidence of tetracycline resistance. In 52.3% of the strains, multi-drug resistance was found. Plasmids were not found, but chromosomal genetic determinants of resistance to these drugs were identified. These included mutations in 23S rRNA, gyrA, and pbp1 A. Furthermore, rdxA missense, frameshift, and nonsense mutations were found to be genetic predictors of metronidazole resistance. The study revealed chromosomal mutations affecting the targets of these antibiotics and pbp1 A, gyrA, rdxA and 23S rRNA, were the primary source of resistance in H. pylori. Given the high prevalence of H. pylori resistance to these drugs, our findings emphasize the necessity of routine examination and alternate treatments in these districts. Additionally, our work showed how well NGS can identify genetic resistance factors and how it might be used in treatment plans.