Antibiotic resistance of <i>Helicobacter pylori</i> in Australia and New Zealand: A systematic review and meta‐analysis

Schubert, Jonathon P; Gehlert, Jessica; Rayner, Christopher K.; Roberts‐Thomson, Ian C.; Mangoni, Arduino A.; Bryant, Robert V.

doi:10.1111/jgh.15352

“…In Australia, between 15% and 30% of the population have H. pylori infection 12,13 . Varying ranges of antibiotic resistance and increasing rates of clarithromycin resistance have also been reported in Australia 14,15 . Known risk factors for the development of resistant strains include prior antibiotic exposure, national antibiotic consumption, and smoking 16–18 .…”

Section: Introductionmentioning

confidence: 99%

Geospatial analysis of Helicobacter pylori infection in South Australia: Should location influence eradication therapy?

Schubert

¹

,

Woodman

²

,

Mangoni

³

et al. 2022

J of Gastro and Hepatol

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Background and Aim Rates of antimicrobial‐resistant Helicobacter pylori infection are rising globally; however, geospatial location and its interaction with risk factors for infection have not been closely examined. Methods Gastric biopsy specimens were collected to detect H. pylori infection at multiple centers in Adelaide, South Australia, between 1998 and 2017. The geospatial distribution of antibiotic‐resistant H. pylori in the Greater Adelaide region was plotted using choropleth maps. Moran's I was used to assess geospatial correlation, and multivariate linear regression (MLR) was used to examine associations between migration status, socioeconomic status, age, gender, and rates of H. pylori positivity and antibiotic resistance. Geographically weighted regression (GWR) was used to determine the extent to which the associations varied according to geospatial location. Results Of 20 108 biopsies across 136 postcodes within the Greater Adelaide region, 1901 (9.45%) were H. pylori positive. Of these, 797 (41.9%) displayed clarithromycin, tetracycline, metronidazole, or amoxicillin resistance. In MLR, migration status was associated with the rate of H. pylori positivity (β = 3.85% per 10% increase in a postcode's migrant population; P < 0.001). H. pylori positivity and resistance to any antibiotic were geospatially clustered (Moran's I = 0.571 and 0.280, respectively; P < 0.001 for both). In GWR, there was significant geospatial variation in the strength of the migrant association for both H. pylori positivity and antibiotic resistance. Conclusion Our study demonstrates the heterogeneous geospatial distribution of H. pylori positivity and antibiotic resistance, as well as its interaction with migrant status. Geographic location and migrant status are important factors to consider for H. pylori eradication therapy.

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“…Antibiotic resistance is divided into primary and secondary resistance (40). The antibiotic resistance rate increases in association with the number of therapy failures (38).…”

Section: Discussionmentioning

confidence: 99%

Study on the value of antibiotic‑resistant gene detection in Helicobacter pylori in China

Dai

¹

,

Zhao

²

,

Mao

³

et al. 2022

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The aim of the present study was to explore the value of detecting antibiotic-resistant genes in Helicobacter pylori (H. pylori) and the association between genotype and antibiotic resistance. Two gastric mucosa samples from each H. pylori-positive patient were collected. Each patient's H. pylori sample was cultured in vitro, and the agar plate dilution method was conducted. In addition, all patient samples were analyzed for the detection of antibiotic resistance-related mutant genes and VacA gene genotypes. The association between VacA genotypes and antibiotic resistance was also determined and the value of mutant gene detection in predicting H. pylori resistance to antibiotics was evaluated. In total, 133 H. pylori-positive patients were enrolled. A total of 22 strains of H. pylori failed to grow in in vitro culture and 25 strains were negative in a H. pylori gene test. Among 108 strains detected by PCR, a total of 39 VacA s1m1 strains, 69 VacA s1m2 strains and no VacA s2 strain were identified. There was no significant association between VacA genotypes and antibiotic resistance. The mutation rates of G616A in the rdxA gene, T87A, G91A, A91G and G91T in the gyrA gene and A2143G and A2142G in the 23S rRNA gene were 32. 1, 32.3, 22.6, 12.9, 6.5, 81.8 and 0.0%, respectively. Among these mutant sites, the mutation coincidence rates were as follows, according to the agar plate dilution method: rdxA G616A (81.8%), gyrA G91T (66.7%), gyrA G91A (54.5%), 23 S rRNA A2143G (49.1%), gyrA T87A (45.5%), gyrA A91G (33.3%), penicillin-binding protein 1 (PBP1) C556G (0.0%), PBP1 A562T (0.0%), PBP1 A562G (0.0%) and 16 S rRNA 926-927 (AT-GT) (0.0%). VacA m subtypes were not associated with H. pylori antibiotic resistance. In conclusion, the present findings suggested that the detection of related mutant genes had a clinical application value in predicting the antibiotic resistance of H. pylori, particularly resistance to clarithromycin and levofloxacin.

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“…Clarithromycin-containing regimens are recommended as first-line drugs. However, the increasing rate of antibiotic resistance has already influenced the treatment of CNG [ 1 ]. Moreover, proton pump inhibitors (PPIs), such as omeprazole, esomeprazole, and lansoprazole, are also important medicines that could reduce the damage to the mucosa that is induced by gastric acid.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Zuojin Pill for the Treatment of Chronic Nonatrophic Gastritis: A Randomized Active-Controlled Clinical Trial

Wang

¹

,

Lu

²

,

Jing

³

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. Zuojin pill (ZJP) is used as the classical prescription for a wide variety of digestive diseases. However, there is a lack of direct evidence for its use in the treatment of chronic nonatrophic gastritis (CNG). In particular, there is a lack of rigorous trials of randomized controlled designs. In this study, a randomized active-controlled clinical trial was performed to verify the efficacy and safety of ZJP in detail. Methods. Patients with CNG were divided into the ZJP group and the Marzulene-S granule group. Patients were enrolled from September 2019 to February 2021 (ChiCTR2000040549). Endoscopy and histology scores were evaluated as the primary outcome measure. The Helicobacter pylori positive rate and the disappearance rate of symptoms were also measured to reflect the outcomes. Finally, adverse events were also calculated as the index of safety. Results. A total of 68 eligible patients were enrolled in this trial and randomly divided into two groups with baseline comparability. ZJP was able to improve the red plaques as well as bile reflux scores compared with Marzulene-S granule ( P = 0.043 and P = 0.019 , respectively). Moreover, it also remarkably alleviated the active chronic inflammation score P = 0.043 . However, there was no difference between the Helicobacter pylori positivity rate P = 0.752 . The symptom scores of abdominal distension P = 0.004 , belching P = 0.010 , and loss of appetite P = 0.019 were alleviated by ZJP, but nausea and vomiting were not P = 0.616 . ZJP can also be considered safe with no obvious adverse effects. Conclusion. ZJP might decrease mucosal injury and alleviate symptoms in CNG. In addition, more large-scale clinical trials should be carried out to further confirm its clinical efficacy and safety.

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Antibiotic resistance of Helicobacter pylori in Australia and New Zealand: A systematic review and meta‐analysis

Cited by 20 publications

References 46 publications

Geospatial analysis of Helicobacter pylori infection in South Australia: Should location influence eradication therapy?

Geospatial analysis of Helicobacter pylori infection in South Australia: Should location influence eradication therapy?

Study on the value of antibiotic‑resistant gene detection in Helicobacter pylori in China

Efficacy and Safety of Zuojin Pill for the Treatment of Chronic Nonatrophic Gastritis: A Randomized Active-Controlled Clinical Trial

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