Antibiotic resistance characteristics and risk factors analysis of Helicobacter pylori strains isolated from patients in Liaoning Province, an area in North China

PeerJ. 2023 May 16:11:e15268. doi: 10.7717/peerj.15268. eCollection 2023.

Abstract

Background: The prevalence of Helicobacter pylori (H. pylori) keeps rising while the eradication rate continues to decline due to the increasing antibiotic resistance. Regional variations of antimicrobial resistance to H. pylori have been recommended by guidelines in recent years. This study aims to investigate the antibiotic resistance rate of H. pylori and its association with infected subjects' characteristics in Liaoning Province, an area in north China.

Methods: Gastric tissues from 178 H. pylori positive participants without previous antibiotic use within four weeks were collected for H. pylori culture. Antibiotic susceptibility to furazolidone (AOZ), tetracycline (TC), levofloxacin (LFX), metronidazole (MET), clarithromycin (CLA), and amoxicillin (AMX) were examined with the agar dilution method. Associations between H. pylori resistance and patient characteristics were further analysed.

Results: No resistance was observed in AOZ or TC. For LFX, MET, CLA, and AMX, the overall resistance rates were 41.10%, 79.14%, 71.78%, and 22.09% respectively. There were significant differences between resistance to CLA and MALToma (P = 0.021), and between resistance to MET and age (P < 0.001).

Conclusions: The primary resistant rates of LEX, MET, CLA, and AMX were relatively high in Liaoning. Treatment effectiveness improvement could be achieved by prior antimicrobial susceptibility tests before antibiotic prescription.

Keywords: Antibiotic resistance; Eradication; Helicobacter pylori; Liaoning Province; Multi-resistance; Regional characteristic.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amoxicillin
  • Anti-Bacterial Agents / pharmacology
  • China / epidemiology
  • Clarithromycin / pharmacology
  • Drug Resistance, Bacterial
  • Helicobacter Infections* / drug therapy
  • Helicobacter pylori*
  • Humans
  • Levofloxacin / pharmacology
  • Metronidazole
  • Risk Factors
  • Tetracycline / pharmacology

Substances

  • Anti-Bacterial Agents
  • Clarithromycin
  • Metronidazole
  • Amoxicillin
  • Levofloxacin
  • Tetracycline

Grants and funding

This work was supported by the Fund for Liaoning Province Science and Technology Plan Project: Study on Pathogenicity and Antibiotic Resistance of HofE-positive Helicobacter pylori Strains (NO. 20180550049) and the Fund for Scientific Research of The First Hospital of China Medical University: Biological Effect and Pathogenic Mechanism of Helicobacter pylori Outer Membrane Protein HofE (NO. FHCMU-FSR). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.