Characteristics of phenotypic antibiotic resistance of Helicobacter pylori and its correlation with genotypic antibiotic resistance: A retrospective study in Ningxia |
| |
| Authors: | Shengjuan Hu Yan Zhou Yanhong Deng Yang Bo Xianmei Chen Wei Yang Ruichun Shi Wei Zhao Zhanbing Hou Jianping Hu Jianguo Liu Xilong Zhang Heli Yong Ping Wang Fei Li Hailong Qi Xiaoyun Wang Lijuan Jin Ting Cui Haijiang Yong Xue Li Bin Yang Yuehua Yu Bin Ma Lei Fu Xuemei Wang Zhen Ma Na Tang Yanjie You Jianyang Guo Xiaobing Yu Li Yao Ruiping Gao Yanling Li Ruijuan Xin Jianfang Liu Zhenzi Cao Hongliang Li Linke Ma Shoucheng Ma Ying Cao Yuanyuan Tang Jun Liu Qian Hao Xiaofei Li Xuemei Li Rui Mu Min Niu Xiaoming Su Hengjun Gao |
| |
| Institution: | 1. People's Hospital of Ningxia Hui Autonomous Region (Ningxia Medical University Affiliated People's Hospital of Autonomous Region), Yinchuan, China;2. Ningxia Integrated Traditional Chinese and Western Medicine Hospital, Yinchuan, China;3. Department of Gastroenterology, Wuzhong People's Hospital, Wuzhong, China;4. Department of Gastroenterology, Yanchi People's Hospital, Yanchi, China;5. Department of Gastroenterology, Yinchuan First People's Hospital, Yinchuan, China;6. Department of Gastroenterology, Zhongwei People's Hospital, Zhongwei, China;7. Department of Gastroenterology, People's Hospital of Pingluo County, Pingluo, China;8. Department of Gastroenterology, Guyuan Yuanzhou District People's Hospital, Guyuan, China;9. Department of Gastroenterology, The Fifth People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China;10. Department of Gastroenterology, Second People's Hospital of Shizuishan, Shizuishan, China;11. Department of Gastroenterology, Shizuishan First People's Hospital, Shizuishan, China;12. Tongji Hospital, School of Medicine, Tongji University, Shanghai, China |
| |
| Abstract: | Background Geographic differences exist in the antibiotic resistance patterns of Helicobacter pylori. Personalized treatment regimens based on local or individual resistance data are essential. We evaluated the current status of H. pylori resistance in Ningxia, analyzed resistance-related factors, and assessed the concordance of phenotypic and genotypic resistance. Methods Strains were isolated from the gastric mucosa of patients infected with H. pylori in Ningxia and relevant clinical information was collected. Phenotypic antibiotic susceptibility assays (Kirby–Bauer disk diffusion) and antibiotic resistance gene detection (Sanger sequencing) were performed. Results We isolated 1955 H. pylori strains. The resistance rates of H. pylori to amoxicillin, levofloxacin, clarithromycin, and metronidazole were 0.9%, 42.4%, 40.4%, and 94.2%, respectively. Only five tetracycline-resistant and one furazolidone-resistant strain were identified. Overall, 3.3% of the strains were sensitive to all six antibiotics. Multidrug-resistant strains accounted for 22.9%, of which less than 20% were from Wuzhong. Strains isolated from women and patients with nonulcerative disease had higher rates of resistance to levofloxacin and clarithromycin. Higher rates of resistance to metronidazole, levofloxacin, and clarithromycin were observed in the older age group than in the younger age group. The kappa coefficients of phenotypic resistance and genotypic resistance for levofloxacin and clarithromycin were 0.830 and 0.809, respectively, whereas the remaining antibiotics showed poor agreement. Conclusion H. pylori antibiotic resistance is severe in Ningxia. Therefore, furazolidone, amoxicillin, and tetracycline are better choices for the empirical therapy of H. pylori infection in this region. Host sex, age, and the presence of ulcerative diseases may affect antibiotic resistance of the bacteria. Personalized therapy based on genetic testing for levofloxacin and clarithromycin resistance may be a future direction for the eradication therapy of H. pylori infection in Ningxia. |
| |
| Keywords: | antibiotic resistance eradication therapy gastric disease genotype Helicobacter pylori phenotype |
|
|
