Title : Antibiotic resistance profile of helicobacter pylori to 14 antibiotics: A multicenter study in Fujian, China
Abstract:
Aim: Efficacy of Helicobacter pylori (H. Pylori) eradication is related to the local antimicrobial resistance epidemiology. Our aim was to investigate the antibiotic resistance of H. Pylori in Fujian, China.
Methods: H. Pylori -infected patients in four centers in Fujian were enrolled in the study from Oct 2019 to Jan 2022. The bacteria were isolated, cultured and identified from the biopsy samples of gastric mucosa of patients. Antimicrobial susceptibility test was performed by broth microdilution method for H. pylori strains to seven guideline-recommended antibiotics (amoxicillin (AMX), tetracycline (TET), clarithromycin (CLR), levofloxacin (LVFX), metronidazole (MTZ), rifampicin (RFP) and furazolidone (FZD) ) and seven potential choices (amoxicillin and clavulanate potassium (AMC), cefixime(CFM), gentamicin (GEN), doxycycline(DOX), azithromycin(AZM), sparfloxacin (SPFX), tinidazole (TID).
Results: A total of 205 H. pylori strains were successfully isolated from the biopsy
Samples of gastric mucosa. The antibiotic resistance rates of AMX, AMC, CFM, GEN, TET, DOX, AZM, CLR, LVFX, SPFX, MTZ, TID, RFP and FZD were 11.22%, 12.20%, 7.32%, 12.20%, 4.88%, 4.39%, 44.39%, 43.90%, 30.24%, 21.46%, 40.98%, 45.85%, 5.37% and 10.24%, respectively. The rates of pan-sensitivity, single resistance, double resistance, triple resistance and multiple resistance for seven guideline-recommended antibiotics were 32.68%, 30.24%, 13.17% and 7.76%, 14.15%, respectively. The main double resistance patterns were CLR+MTZ (10/205, 5%) and CLR+LVFX (9/205, 4%). The main triple resistance patterns were CLR+MTZ+LVFX (15/205, 7%). Only AMC resistance rate in female group was lower than that in male group (6.67% VS 16.52%, P =0.032). For the other 13 antibiotics there was no difference in resistance rates for gender. There were no significant statistical differences of H. pylori resistance among different ages and diseases (P >0.05).
Conclusion: In Fujian Province, the prevalence of H. pylori resistance to AZM, CLR, LVFX, SPFX, MTZ, and TID was high, while the prevalence to AMX, AMC, GEN, CFM, TET, DOX, RFP and FZD was relatively low. CFM and DOX were the promising new choices for H. pylori eradication.
Audience Take Away:
- To our knowledge, this is the first multicenter study in Fujian China to evaluate antibiotic resistance profile of Helicobacter pylori(H. pylori)to 14 antibiotics including seven seven guideline-recommended antibiotics and seven potential choices
- Our study demonstrated that the prevalence of H. pylori resistance to azithromycin, clarithromycin, levofloxacin, sparfloxacin, metronidazole and tinidazole was high, whereas the prevalence of H pylori resistance to amoxicillin, amoxicillin and clavulanate potassium, gentamicin, cefixime, doxycycline, tetracycline, rifampicin and furazolidone was relatively low in Fujian. Cefixime and doxycycline were the promising new choices for H. pylori eradication
- This research that other faculty could use to expand their research or teaching in Helicobater pylori infection
- This research will provide a practical solution to the problem that patients with Helicobater pylori infection
