Infection and Drug Resistance (Sep 2022)
Antibiotics Resistance Prevalence of Helicobacter pylori Strains in Northwest China
Abstract
Huimei Xu,1 Jianwei Yun,1 Ruiying Li,1 Xueni Ma,1 Lingzhu Gou,1 Tuanjie Che,2 Dekui Zhang1,3 1Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou, People’s Republic of China; 2Department of Center of Genomics, Key Laboratory of Functional Genomics and Molecular Diagnosis of Gansu Province, Lanzhou, People’s Republic of China; 3Department of Gastroenterology, Key Laboratory of Digestive Diseases of Lanzhou University Second Hospital, Lanzhou, People’s Republic of ChinaCorrespondence: Dekui Zhang; Tuanjie Che, Lanzhou University Second Hospital, Cuiying Number 82, Chengguan District, Lanzhou, People’s Republic of China, Tel/Fax +86 17797634824, Email [email protected]; [email protected]: This study aims to estimate the resistance rate of Helicobacter pylori (HP) to commonly used antibiotics and analyze the potential influencing factors in northwest regions of China.Patients and Methods: HP-positive patients visiting the outpatient department of multiple hospitals were enrolled in the study. Then, gastric mucosal biopsy specimens were collected for HP isolation, culture, and investigation of the resistance rate of HP to amoxicillin, metronidazole, tetracycline, levofloxacin, and clarithromycin by Epsilometer test (E-test) antibiotic susceptibility testing. In addition, multi-drug resistance, the influence of HP eradication history, age, and region of residence on drug resistance rate were analyzed.Results: In total, 198 HP clinical strains were successfully isolated and cultured. The resistance rates of amoxicillin, metronidazole, tetracycline, levofloxacin, and clarithromycin were 16.16%, 85.86%, 7.58%, 46.46%, and 55.05%, respectively. The multi-drug resistance rates demonstrated that dual and triple resistances were 30.30% and 22.73%, respectively. The quadruple resistance rate reached 9.60%. Our results revealed that the prior eradication history of HP significantly increased levofloxacin and clarithromycin resistance. Metronidazole and levofloxacin resistances significantly differed among different age groups, which presented an upward trend with increasing age. Drug resistance rates varied with geographic regions, especially amoxicillin and clarithromycin resistance, which were highest in Hexi Corridor and Longnan regions.Conclusion: The current situation of HP resistance to common antibiotics is severe. Tetracycline is the most sensitive antibiotic, followed by amoxicillin, the first choice for HP eradication. However, the eradication failure of HP may lead to an increase in the resistance rate. Therefore, it is necessary to strengthen the standardized diagnosis and treatment of HP to improve the primary eradication rate.Keywords: Helicobacter pylori, antibiotic, drug resistance, eradication
