D-S Liu1, Y-H Wang1, Z-R Zeng2, Z-Y Zhang3, H Lu4, J-M Xu5, Y-Q Du6, Y Li7, J-B Wang8, S-P Xu9, Y Chen10, C-H Lan11, H Cheng12, M-D Jiang13, L-X Zhang14, L-J Huo15, S-Y Chen16, G-X Zhang17, K-C Wu18, X Zhu1, Y-X Chen1, Y Zhu1, X Shu1, Y Xie19, N-H Lu20. 1. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China. 2. Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong Province, China. 3. Department of Gastroenterology, Nanjing First Hospital, Jiangsu, China. 4. Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 5. Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Anhui, China. 6. Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China. 7. Department of Gastroenterology, Shengjing Hospital Affiliated to China Medical University, Liaoning Province, China. 8. Department of Gastroenterology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China. 9. Department of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, HuBei Province, China. 10. Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China. 11. Department of Gastroenterology, Daping Hospital and the Research Institute of Surgery of the Third Military Medical University, Chongqing, China. 12. Department of Gastroenterology, Peking University First Hospital, Beijing, China. 13. Department of Gastroenterology, General Hospital of Chengdu Military Region, Sichuan Province, China. 14. Department of Gastroenterology, Xi'an Central Hospital, Shaanxi Province, China. 15. Department of Gastroenterology, First Clinical Medical College, Shanxi Medical University, Shanxi Province, China. 16. Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China. 17. Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China. 18. Xijing Hospital of the Fourth Military Medical University, Xi'an, China. 19. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China. Electronic address: xieyong_tfahoncu@163.com. 20. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China. Electronic address: lunonghua@ncu.edu.cn.
Abstract
OBJECTIVES: To explore the characteristics of Helicobacter pylori resistance in China and the association between antibiotic resistance and several clinical factors. METHODS: H. pylori strains were collected from patients in 13 provinces or cities in China between 2010 and 2016. Demographic data including type of disease, geographic area, age, gender and isolation year were collected to analyse their association with antibiotic resistance. Antibiotic resistance was detected using the Etest test and the Kirby-Bauer disc diffusion method. RESULTS: H. pylori were successfully cultured from 1117 patients. The prevalence of metronidazole, clarithromycin (CLA), azithromycin, levofloxacin (LEV), moxifloxacin, amoxicillin (AMO), tetracycline and rifampicin resistance was 78.2, 22.1, 23.3, 19.2, 17.2, 3.4, 1.9 and 1.5%, respectively. No resistance to furazolidone was observed. The resistance rates to LEV and moxifloxacin were higher in strains isolated from patients with gastritis compared to those with duodenal ulcer and among women. Compared to patients ≥40 years old, younger patients exhibited lower resistance rates to CLA, azithromycin, LEV and moxifloxacin. The resistance rates to CLA and AMO were higher in strains isolated more recently, and we also found that the prevalence of resistance to metronidazole, CLA, azithromycin and AMO were significantly different among different regions of China. CONCLUSIONS: The resistance rates to metronidazole, CLA and LEV were high in China. Patient age, gender, disease and location were associated with the resistance of H. pylori to some antibiotics. Furazolidone, AMO and tetracycline are better choices for H. pylori treatment in China.
OBJECTIVES: To explore the characteristics of Helicobacter pylori resistance in China and the association between antibiotic resistance and several clinical factors. METHODS: H. pylori strains were collected from patients in 13 provinces or cities in China between 2010 and 2016. Demographic data including type of disease, geographic area, age, gender and isolation year were collected to analyse their association with antibiotic resistance. Antibiotic resistance was detected using the Etest test and the Kirby-Bauer disc diffusion method. RESULTS: H. pylori were successfully cultured from 1117 patients. The prevalence of metronidazole, clarithromycin (CLA), azithromycin, levofloxacin (LEV), moxifloxacin, amoxicillin (AMO), tetracycline and rifampicin resistance was 78.2, 22.1, 23.3, 19.2, 17.2, 3.4, 1.9 and 1.5%, respectively. No resistance to furazolidone was observed. The resistance rates to LEV and moxifloxacin were higher in strains isolated from patients with gastritis compared to those with duodenal ulcer and among women. Compared to patients ≥40 years old, younger patients exhibited lower resistance rates to CLA, azithromycin, LEV and moxifloxacin. The resistance rates to CLA and AMO were higher in strains isolated more recently, and we also found that the prevalence of resistance to metronidazole, CLA, azithromycin and AMO were significantly different among different regions of China. CONCLUSIONS: The resistance rates to metronidazole, CLA and LEV were high in China. Patient age, gender, disease and location were associated with the resistance of H. pylori to some antibiotics. Furazolidone, AMO and tetracycline are better choices for H. pylori treatment in China.