Clinical analysis of antibiotic resistance to Helicobacter pylori in central Zhejiang of China

Abstract

Objective To analyze the antibiotic resistance and clinical characteristics of Helicobacter pylori (H. pylori) in central of Zhejiang province. Methods A total of 296 strains of H. pylori isolated from May 2015 to August 2015 in Jinhua Central Hospital. The resistance and clinical characteristics of these strains to metronidazole, levofloxacin, clarithromycin, furazolidone, amoxicillin, gentamicin and tetracycline were analyzed in vitro. All the strains were divided into different groups according to gender [male group (139 strains) and female group (157 strains)], age [17 ~ 35 years group (58 strains), 36 ~ 55 years group (157 strains), 56 ~ 79 years group (81 strains), and disease types [inflammation group (212 strains) and ulceration group (84 strains)], respectively. Results Of the 296 strains of H. pylori, the rate of resistance to metronidazole, levofloxacin, clarithromycin were 86.8% (257/296), 35.1% (104/296) and 22.3%(66/296), respectively. No strains were resistant to furazolidone, amoxicillin, gentamicin and tetracycline. 12.50% of H. pylori isolates were susceptible to all tested antibiotic (37/296), with mono 44.60% (resistance to metronidazole 130 strains, to levofloxacin 1 strains, to clarithromycin 1 strains), double 29.05% (resistance to levofloxacin and metronidazole 62 strains, and to levofloxacin and clarithromycin 24 strains), and triple 13.85% (resistance to levofloxacin, metronidazole and clarithromycin 41 strains). Meanwhile, the resistance rate of levofloxacin was higher in the female group than that in the male group (41.4% vs. 28.1%, χ2=5.760, P=0.016), and were 19.0%, 42.0%, 33.3%, respectively, in the 17-35 years group, 36-55 years group, and 56-79 years group with significant differences (χ2=10.052, P=0.007), and it was much lower in the 17-35 years group than that in the 36 ~ 55 years group (P=0.002). However, the resistance rates of metronidazole(37.3% vs. 29.8%, χ2=1.486, P=0.223), levofloxacin (86.3% vs. 88.1%, χ2=0.166, P=0.684), clarithromycin (25.0% vs. 15.5%, χ2=3.150, P=0.076) were not statistically different between the inflammation group and ulceration group. Conclusions H. pylori resistance to metronidazole, levofloxacin and clarithromycin were high in the central Zhejiang, and gender and age were related to levofloxacin resistance. It is necessary to strictly follow the guidelines of antibiotic treatment and make an individual treatment according to the results of drug sensitive test, thereby increase the eradication rate of H. pylori. Key words: Helicobacter pylori; Antibiotic resistance; Clinical characteristics