Primary antibiotic resistance of Helicobacter pylori in Chinese patients: a multiregion prospective 7-year study.

Abstract

OBJECTIVES:

To explore the characteristics of Helicobacter pylori resistance in China and the association between antibiotic resistance and several clinical factors.

METHODS:

H. pylori strains were collected from patients in 13 provinces or cities in China between 2010 and 2016. Demographic data including type of disease, geographic area, age, gender and isolation year were collected to analyse their association with antibiotic resistance. Antibiotic resistance was detected using the Etest test and the Kirby-Bauer disc diffusion method.

RESULTS:

H. pylori were successfully cultured from 1117 patients. The prevalence of metronidazole, clarithromycin (CLA), azithromycin, levofloxacin (LEV), moxifloxacin, amoxicillin (AMO), tetracycline and rifampicin resistance was 78.2, 22.1, 23.3, 19.2, 17.2, 3.4, 1.9 and 1.5%, respectively. No resistance to furazolidone was observed. The resistance rates to LEV and moxifloxacin were higher in strains isolated from patients with gastritis compared to those with duodenal ulcer and among women. Compared to patients ≥40 years old, younger patients exhibited lower resistance rates to CLA, azithromycin, LEV and moxifloxacin. The resistance rates to CLA and AMO were higher in strains isolated more recently, and we also found that the prevalence of resistance to metronidazole, CLA, azithromycin and AMO were significantly different among different regions of China.

CONCLUSIONS:

The resistance rates to metronidazole, CLA and LEV were high in China. Patient age, gender, disease and location were associated with the resistance of H. pylori to some antibiotics. Furazolidone, AMO and tetracycline are better choices for H. pylori treatment in China.

• Authors: D-S Liu, Y-H Wang, Z-R Zeng, Z-Y Zhang, H Lu, J-M Xu, Y-Q Du, Y Li, J-B Wang, S-P Xu, Y Chen, C-H Lan, H Cheng, M-D Jiang, L-X Zhang, L-J Huo, S-Y Chen, G-X Zhang, K-C Wu, X Zhu, Y-X Chen, Y Zhu, X Shu, Y Xie, N-H Lu
• Journal: Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases (Clin Microbiol Infect) Vol. 24 Issue 7 Pg. 780.e5-780.e8 (Jul 2018) ISSN: 1469-0691 [Electronic] England
• PMID: 29138101 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Metronidazole
• Levofloxacin
• Clarithromycin

Topics

• Adult
• Anti-Bacterial Agents (pharmacology)
• China
• Clarithromycin (pharmacology)
• Drug Resistance, Bacterial (drug effects, physiology)
• Female
• Helicobacter Infections (microbiology)
• Helicobacter pylori (drug effects, isolation & purification, physiology)
• Humans
• Levofloxacin (pharmacology)
• Male
• Metronidazole (pharmacology)
• Microbial Sensitivity Tests
• Microbial Viability (drug effects)
• Risk Factors