Zhongguo quanke yixue (Mar 2023)
The Helicobacter Pylori Antibiotic Resistance in Wenzhou, Zhejiang from 2013 to 2020
Abstract
Background Helicobacter pylori (H. pylori) infection is the main cause of gastric cancer, but with the increase of H. pylori antibiotic resistance, the eradication rate has not substantially improved in many areas. Objective To understand the H. pylori antibiotic resistance situation in Wenzhou from 2013—2020, and analyse the difference of H. pylori antibiotic resistance with time period, age and gender. Methods From 2013-01-01 to 2020-12-31, a total of 47 658 patients undergoing gastroscopy in Wenzhou Central Hospital were selected. Gastric mucosa specimens were collected for H. pylori isolation and culture, and the isolated H. pylori strains obtained from the culture were analyzed for drug susceptibility to six antibiotics, including levofloxacin, clarithromycin, amoxicillin, metronidazole, tetracycline and furazolidone. A chi-square test was used to compare H. pylori antibiotic resistance rate between years, age groups and sexes. Results Multiple antibiotic resistance existed in 16 847 H. pylori strains isolated in Wenzhou from 2013—2020. Separate statistics on the resistance rates of H. pylori to the six commonly used antibiotics revealed that the resistance rates to levofloxacin, clarithromycin and metronidazole were high in the region, respectively 32.81% (5 536/16 874) 、26.02% (4 390/16 874) 、95.67% (16 144/16 874) . The resistance rate to amoxicillin was low, only 0.28% (47/16 874) , and 1.36% (25/1 844) in 2017. No strains were found with resistance to tetracycline hydrochloride and furazolidone. From 2013 to 2020, there were statistically significant differences in H. pylori resistance rates to levofloxacin, clarithromycin and amoxicillin (P<0.01) . The metronidazole resistance rate in H. pylori was consistently high (>88.00%) with no statistical difference (P>0.05) . There was statistically significant difference in the H. pylori resistance rate for evofloxacin, clarithromycin and metronidazole between female and male (P<0.01) , with no statistical difference for amoxicillin (P>0.05) . There was statistically significant difference in the H. pylori resistance rate for levofloxacin or clarithromycin among different age groups in the region (P<0.01) , with no statistical difference for amoxicillin and metronidazole (P>0.05) . Conclusion The H. pylori antibiotic resistance rate differed by year, and varied across different age and sex groups of H. pylori-positive cases in Wenzhou during the period. The overall H. pylori resistance rate was high. The eradication regimens based on metronidazole, clarithromycin or levofloxacin are difficult to achieve satisfactory results, so clinical H. pylori eradication treatment based on drug sensitivity test results should be encouraged.
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