Journal of global antimicrobial resistance · 2025
Helicobacter pylori antimicrobial resistance and CYP2C19 genotypes in a paediatric cohort with initial eradication failure: A study from Henan, China (2019-2024).
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Xue Fumin, Hou Jiangshan, An Chao, Yu Jing, Zhou Fang, Sun Bo, Ding Cong, Zhou Qiang
Аннотация
OBJECTIVE: To investigate the antibiotic resistance profile of Helicobacter pylori (H. pylori) strains and the CYP2C19 gene polymorphisms in initial eradication failure children from Henan, China (2019-2024).
METHODS: A retrospective cohort study included 207 children diagnosed with H. pylori infection by gastric mucosal histopathology. Participants were categorized by endoscopic findings: normal mucosa (NM), gastritis (GA), or peptic ulcer disease (PUD). Antimicrobial susceptibility testing was performed for amoxicillin (AML), furazolidone (FZD), metronidazole (MTZ), clarithromycin (CLA), tetracycline (TET), and levofloxacin (LEV). CYP2C19 genotyping was conducted via PCR.
RESULTS: The annual number of cases increased from 13 in 2019 to 75 in 2024. Abdominal pain (89.4%) and loss of appetite (74.9%) were the most common symptoms. Endoscopic findings were primarily GA (57.0%). Resistance to FZD and TET was undetected (0%), and AML resistance was low (1.45%). High resistance rates were observed for MTZ (75.85%), CLA (75.36%), and LEV (22.22%). Dual MTZ+CLA resistance reached 61.35%, with the highest rate (18.1%) among 13-y-olds. Triple resistance (MTZ+CLA+LEV) was 16.43%. Both single and multidrug resistance increased significantly over time (P < 0.05). CYP2C19 genotyping revealed extensive metabolizers (EM, *1/*1) in 48.33%, intermediate metabolizers (IM, *1/*2+*1/*3) in 45.00%, and poor metabolizers (PM, *2/*2+*2/*3) in 6.67%.
CONCLUSIONS: The high resistance rates to MTZ and CLA, coupled with the CYP2C19 EM phenotype, may contribute to the failure of initial empirical H. pylori eradication in children from Henan, China. Therefore, for retreatment, it is recommended to tailor an individualized regimen based on antimicrobial susceptibility testing and CYP2C19 genotyping results.
METHODS: A retrospective cohort study included 207 children diagnosed with H. pylori infection by gastric mucosal histopathology. Participants were categorized by endoscopic findings: normal mucosa (NM), gastritis (GA), or peptic ulcer disease (PUD). Antimicrobial susceptibility testing was performed for amoxicillin (AML), furazolidone (FZD), metronidazole (MTZ), clarithromycin (CLA), tetracycline (TET), and levofloxacin (LEV). CYP2C19 genotyping was conducted via PCR.
RESULTS: The annual number of cases increased from 13 in 2019 to 75 in 2024. Abdominal pain (89.4%) and loss of appetite (74.9%) were the most common symptoms. Endoscopic findings were primarily GA (57.0%). Resistance to FZD and TET was undetected (0%), and AML resistance was low (1.45%). High resistance rates were observed for MTZ (75.85%), CLA (75.36%), and LEV (22.22%). Dual MTZ+CLA resistance reached 61.35%, with the highest rate (18.1%) among 13-y-olds. Triple resistance (MTZ+CLA+LEV) was 16.43%. Both single and multidrug resistance increased significantly over time (P < 0.05). CYP2C19 genotyping revealed extensive metabolizers (EM, *1/*1) in 48.33%, intermediate metabolizers (IM, *1/*2+*1/*3) in 45.00%, and poor metabolizers (PM, *2/*2+*2/*3) in 6.67%.
CONCLUSIONS: The high resistance rates to MTZ and CLA, coupled with the CYP2C19 EM phenotype, may contribute to the failure of initial empirical H. pylori eradication in children from Henan, China. Therefore, for retreatment, it is recommended to tailor an individualized regimen based on antimicrobial susceptibility testing and CYP2C19 genotyping results.