Antibiotics Resistance Prevalence of Helicobacter pylori Strains in Northwest China

Huimei Xu; Jianwei Yun; Ruiying Li; Xueni Ma; Lingzhu Gou; Tuanjie Che; Dekui Zhang

doi:10.2147/IDR.S383444

Antibiotics Resistance Prevalence of Helicobacter pylori Strains in Northwest China

Infect Drug Resist. 2022 Sep 20:15:5519-5528. doi: 10.2147/IDR.S383444. eCollection 2022.

Authors

Huimei Xu¹, Jianwei Yun¹, Ruiying Li¹, Xueni Ma¹, Lingzhu Gou¹, Tuanjie Che², Dekui Zhang^{1

3}

Affiliations

¹ Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou, People's Republic of China.
² Department of Center of Genomics, Key Laboratory of Functional Genomics and Molecular Diagnosis of Gansu Province, Lanzhou, People's Republic of China.
³ Department of Gastroenterology, Key Laboratory of Digestive Diseases of Lanzhou University Second Hospital, Lanzhou, People's Republic of China.

Abstract

Purpose: 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.

Grants and funding

This study was supported by the Key R & D Program of Gansu Province [grant number 20YF8FA078]; Natural Science Foundation of Gansu Province [grant number 21JR1RA131]; Key Talent Project of Gansu Province [grant number 2022RCXM071]; Lanzhou Chengguan District Science and Technology Project [grant number 2018SHFZ0037].