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Observational Study
. 2015 Mar 7;21(9):2786-92.
doi: 10.3748/wjg.v21.i9.2786.

Primary antibiotic resistance of Helicobacter pylori strains isolated from patients with dyspeptic symptoms in Beijing: a prospective serial study

Yue-Xi Zhang  1 , Li-Ya Zhou  1 , Zhi-Qiang Song  1 , Jian-Zhong Zhang  1 , Li-Hua He  1 , Yu Ding  1
Affiliations
Observational Study

Primary antibiotic resistance of Helicobacter pylori strains isolated from patients with dyspeptic symptoms in Beijing: a prospective serial study

Yue-Xi Zhang et al. World J Gastroenterol. .

Abstract

Aim: To determine the resistance patterns of Helicobacter pylori (H. pylori) strains isolated from patients in Beijing and monitor the change of antibiotic resistance over time.

Methods: In this prospective, serial and cross-sectional study, H. pylori cultures were successfully obtained from 371 and 950 patients (never receiving eradication) during 2009-2010 and 2013-2014, respectively. Resistance to amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, and rifampicin was determined by Epsilometer test.

Results: The resistance rates of isolates obtained during 2009-2010 were 66.8%, 39.9%, 34.5%, 15.4%, 6.7%, and 4.9% to metronidazole, clarithromycin, levofloxacin, rifampicin, amoxicillin and tetracycline, respectively; and the corresponding rates for isolates during 2013-2014 were 63.4%, 52.6%, 54.8%, 18.2%, 4.4% and 7.3%, respectively. The resistance rates to clarithromycin and levofloxacin were significantly increased after four years. In 2009-2010, 14.6% of H. pylori isolates were susceptible to all tested antibiotics, with mono (33.7%), double (28.3%), triple (16.7%), quadruple (6.2%), quintuple (0.3%) and sextuple resistance (0.3%) also being detected. In 2013-2014, 9.4% were susceptible to all tested antibiotics, and mono (27.6%), double (28.4%), triple (24.9%), quadruple (7.3%), quintuple (2.3%) and sextuple resistance (0.1%) was also observed. More multiple resistant H. pylori isolates were found during 2013-2014. Gender (to levofloxacin and metronidazole), age (to levofloxacin) and endoscopic findings (to clarithromycin) were independent factors influencing antibiotic resistance.

Conclusion: H. pylori resistance to commonly used antibiotics in Beijing is high with increased multiple antibiotic resistance.

Keywords: Antibiotic resistance; Beijing; Dyspeptic symptoms; Helicobacter pylori.

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Figures

Figure 1
Figure 1
Comparisons of overall antibiotic resistance rates between the two groups. AMX: Amoxicillin; CLA: clarithromycin; LEV: Levofloxacin; MTZ: Metronidazole; RIF: Rifampicin; TET: Tetracycline.
Figure 2
Figure 2
Comparisons of multiple antibiotic resistance rates between the two groups.
See this image and copyright information in PMC

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