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High frequency of mutations at position 2144 of the 23S rRNA gene in clarithromycin-resistant Helicobacter pylori strains isolated in Spain.

Sutcliffe (CGC). It should be remembered, however, that this TEM-1-like sequence has been selected back from TRC-1, in which the amino acid at position 244 was Ser (AGC), not Arg (CGC). The various amino acid substitutions are shown in the Table. The findings of this study confirm at the DNA level that forward mutations from TEM-1 to an IRT variant and back mutations from TRC-1 to TEM-1 are possible in vitro and suggest that such mutations are also likely to occur in vivo as the selective pressures of -lactamase inhibitors are applied and removed.