4 years ago

Primary antibiotic resistance of Helicobacter pylori in Chinese patients: A multi-region prospective 7-year study

To explore the characteristics of H. 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/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 Epsilometer test and the Kirby-Bauer disk diffusion method. Results H. pylori were successfully cultured from 1117 patients. The prevalence of metronidazole, clarithromycin, azithromycin, levofloxacin, moxifloxacin, amoxicillin, 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 levofloxacin and moxifloxacin were higher in strains isolated from patients with gastritis compared to those with duodenal ulcer and among women. Compared with patients ≥40 years old, younger patients exhibited lower resistance rates to clarithromycin, azithromycin, levofloxacin and moxifloxacin. The resistance rates to clarithromycin and amoxicillin were higher in strains isolated more recently, and we also found that the prevalence of resistance to metronidazole, clarithromycin, azithromycin and amoxicillin were significantly different among different regions of China. Conclusions The resistance rates to metronidazole, clarithromycin, levofloxacin were high in China. Patient age, gender, disease and location were associated with the resistance of H. pylori to some antibiotics. Furazolidone, amoxicillin and tetracycline are better choices for H. pylori treatment in China.

Publisher URL: www.sciencedirect.com/science

DOI: S1198743X17306407

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