Abstract
AimsTo describe the characteristics of Helicobacter pylori (H. pylori) antibiotic resistance in clinical isolates from four populations.MethodsIn total, 1463 H. pylori strains were examined for antibiotic resistance. Among these strains, 804 were isolated from treatment-naïve adults, 133 from previously treated adults, 100 from treatment-naïve children and 426 from a population who participated in a health survey (age ≥ 40 years). The minimum inhibitory concentration was determined by the E-test method.ResultsIn the treatment-naïve adult group, the resistance rates for metronidazole, clarithromycin, levofloxacin, amoxicillin, rifampicin and tetracycline were 78.4, 19.0, 23.3, 1.2, 1.7 and 2.3%, respectively. Compared with this group, the previously treated adult group had significantly higher resistance rates for metronidazole (99.2%), clarithromycin (58.3%) and levofloxacin (52.3%). In addition, the treatment-naïve children had a lower metronidazole resistance rate (46.0%) than the treatment-naïve adults. The resistance rate for clarithromycin was low in treatment-naïve patients with ages ranging from 10 to 24 years. For the strains isolated from the general population group, the resistance rates for metronidazole, clarithromycin, levofloxacin, amoxicillin, rifampicin and tetracycline were 78.6, 10.1, 25.1, 0.5, 2.1 and 0.9%, respectively. Compared with the treatment-naïve adult group, the general population group showed significant differences in clarithromycin resistance.ConclusionThe resistance rates for metronidazole, clarithromycin and levofloxacin were high, especially in previously treated adults. Compared to those in treatment-naïve younger patients, the resistance rates for clarithromycin were significantly lower in treatment-naïve patients with ages ranging from 10 to 24 years and in the general population.
Highlights
Helicobacter pylori (H. pylori) is the major pathologic agent in the development of gastritis, peptic ulcers, atrophic gastritis and gastric adenocarcinoma [1, 2]
The present retrospective study was designed to evaluate the prevalence of antibiotic resistance in H. pylori isolates from adults with or without prior anti-H. pylori treatment, treatment-naïve children, and a population who participated in a health survey
804 were isolated from anti-H. pylori treatment-naïve adult patients, 133 were isolated from previously treated adult patients, 100 strains were isolated from anti-H. pylori treatment-naïve children, and 426 strains were isolated from individuals in the general population who participated in a health survey
Summary
Helicobacter pylori (H. pylori) is the major pathologic agent in the development of gastritis, peptic ulcers, atrophic gastritis and gastric adenocarcinoma [1, 2]. Liu et al Antimicrobial Resistance and Infection Control (2019) 8:192 promising therapeutic approach to achieve a good eradication rate [10, 11], but most areas still perform empirical treatment, such as bismuth-containing quadruple or concomitant therapies, as individual antibiotic resistance characteristics are more difficult to determine; among these empirical therapies, metronidazole, clarithromycin, levofloxacin and amoxicillin are widely used. Most studies have focused on patients in hospitals, and the prevalence of antibiotic resistance in the general population remains unclear; in addition, most studies reported resistance rate changes in only adults or children, and fewer studies reported resistance changes in both populations. To address these problems, we performed this study
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