Antibiotic resistance patterns of Helicobacter pylori strains isolated from the Tibet Autonomous Region, China

Abstract

Background The prevalence of Helicobacter pylori antibiotic susceptibility in the Tibet Autonomous Region, China is not determined. This study aimed to evaluate the antibiotic resistance patterns of H. pylori isolates there. Results A total of 153 (38.5%) H. pylori strains were successfully isolated from 397 patients in People's Hospital of Tibet Autonomous Region, China. The overall resistance rates were as follows: clarithromycin (27.4%), levofloxacin (31.3%), metronidazole (86.2%), amoxicillin (15.6%), tetracycline (0%), furazolidone (0.6%), and rifampicin (73.2%). Only 2.0% of H. pylori isolates were susceptible to all tested antimicrobials, with mono resistance, dual resistance, triple resistance, quadruple resistance, and quintuple resistance being 18.3%, 44.4%, 18.3%, 12.4%, and 4.6%, respectively. The resistance rates to levofloxacin (40.5%) and amoxicillin (21.5%) in strains isolated from female patients were significantly higher than those from male patients (21.6% and 9.5%, respectively). Conclusions This study demonstrates high H. pylori resistance rates to clarithromycin, levofloxacin, metronidazole, and rifampicin, whereas moderate resistance to amoxicillin, and negligible resistant to tetracycline, and furazolidone in Tibet Autonomous Region, China. The high resistance to rifampicin warns further investigation of its derivative, rifabutin.

Minocycline/Amoxicillin-Based Bismuth Quadruple Therapy for Helicobacter pylori Eradication: A Pilot Study

“…H. pylori's resistance to tetracycline and amoxicillin remained negligible (<5.0%) in most of the countries [17]. Negligible tetracycline resistance was also reported in more recent studies [14,[22][23][24][25]. In our study population, using MIC > 1.0 mg/L as the resistance breakpoint for both tetracycline and minocycline, the tetracycline resistance rate was 3.0%, and no isolate was found to be resistant to minocycline, suggesting that minocycline resistance is even more rare than tetracycline.…”

Low‐dose or high‐dose amoxicillin in vonoprazan‐based dual therapy for Helicobacter pylori eradication? A systematic review and meta‐analysis

“…This difference may be attributed to varied amoxicillin sensitivity and population characteristics. 36,37 The significance of amoxicillin resistance in the efficacy of VLA dual therapy remains to be investigated. As to the subgroup analysis stratified by amoxicillin frequency, 1000 mg tid (85.8%) and 750 mg qid (86.5%) amoxicillin achieved similar eradication rates.…”

“…In the subgroup analysis stratified by region and country, China and Japan showed eradication rates of 78.2% and 87.0% in VLA dual therapy, respectively. This difference may be attributed to varied amoxicillin sensitivity and population characteristics 36,37 . The significance of amoxicillin resistance in the efficacy of VLA dual therapy remains to be investigated.…”

Antibiotic resistance, susceptibility testing and stewardship in Helicobacter pylori infection

“…In China, double, triple, quadruple, and quintuple resistance rates were reported to be 23, 20, 6, and 4%, respectively between 1998 and 2007 [47]. A study in the Tibet Autonomous Region of China has further demonstrated a high resistance rate where only 3 (2.0%) out of the 153 H. pylori strains isolated were susceptible to all the seven tested antibiotics [48]. In Spain, triple resistance decreased from 3.3% in 2013 to 1.8% in 2015, and then increased to 2.4% in 2017 [49].…”