Characteristics of phenotypic antibiotic resistance of Helicobacter pylori and its correlation with genotypic antibiotic resistance: A retrospective study in Ningxia.
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Hu Shengjuan, Zhou Yan, Deng Yanhong, Bo Yang, Chen Xianmei, Yang Wei, Shi Ruichun, Zhao Wei, Hou Zhanbing, Hu Jianping, Liu Jianguo, Zhang Xilong, Yong Heli, Wang Ping, Li Fei, Qi Hailong, Wang Xiaoyun, Jin Lijuan, Cui Ting, Yong Haijiang, Li Xue, Yang Bin, Yu Yuehua, Ma Bin, Fu Lei, Wang Xuemei, Ma Zhen, Tang Na, You Yanjie, Guo Jianyang, Yu Xiaobing, Yao Li, Gao Ruiping, Li Yanling, Xin Ruijuan, Liu Jianfang, Cao Zhenzi, Li Hongliang, Ma Linke, Ma Shoucheng, Cao Ying, Tang Yuanyuan, Liu Jun, Hao Qian, Li Xiaofei, Li Xuemei, Mu Rui, Niu Min, Su Xiaoming, Gao Hengjun
Аннотация
METHODS: Strains were isolated from the gastric mucosa of patients infected with H. pylori in Ningxia and relevant clinical information was collected. Phenotypic antibiotic susceptibility assays (Kirby-Bauer disk diffusion) and antibiotic resistance gene detection (Sanger sequencing) were performed.
RESULTS: We isolated 1955 H. pylori strains. The resistance rates of H. pylori to amoxicillin, levofloxacin, clarithromycin, and metronidazole were 0.9%, 42.4%, 40.4%, and 94.2%, respectively. Only five tetracycline-resistant and one furazolidone-resistant strain were identified. Overall, 3.3% of the strains were sensitive to all six antibiotics. Multidrug-resistant strains accounted for 22.9%, of which less than 20% were from Wuzhong. Strains isolated from women and patients with nonulcerative disease had higher rates of resistance to levofloxacin and clarithromycin. Higher rates of resistance to metronidazole, levofloxacin, and clarithromycin were observed in the older age group than in the younger age group. The kappa coefficients of phenotypic resistance and genotypic resistance for levofloxacin and clarithromycin were 0.830 and 0.809, respectively, whereas the remaining antibiotics showed poor agreement.
CONCLUSION: H. pylori antibiotic resistance is severe in Ningxia. Therefore, furazolidone, amoxicillin, and tetracycline are better choices for the empirical therapy of H. pylori infection in this region. Host sex, age, and the presence of ulcerative diseases may affect antibiotic resistance of the bacteria. Personalized therapy based on genetic testing for levofloxacin and clarithromycin resistance may be a future direction for the eradication therapy of H. pylori infection in Ningxia.