Prospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2015; 21(9): 2786-2792
Published online Mar 7, 2015. 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, Li-Ya Zhou, Zhi-Qiang Song, Jian-Zhong Zhang, Li-Hua He, Yu Ding
Yue-Xi Zhang, Department of Gastroenterology, Beijing Sixth Hospital, Beijing 100007, China
Li-Ya Zhou, Zhi-Qiang Song, Yu Ding, Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China
Jian-Zhong Zhang, Li-Hua He, State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Author contributions: Zhang YX performed clinical and experimental studies and wrote the manuscript; Zhou LY designed the study and edited the manuscript; Song ZQ performed clinical studies and edited the manuscript; Zhang JZ designed the experimental studies; He LH performed the experimental studies; and Ding Y performed the experimental studies.
Supported by National Science and Technology Pillar Program during the Twelfth Five-year Plan Period, No. 2012BAI06B02; and the Capital Health Research and Development of Special, No. 2011-4032-02.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Li-Ya Zhou, BS, Department of Gastroenterology, Peking University Third Hospital, 49 Huayuan Road, Haidian District, Beijing 100191, China. zhouliya123456@163.com
Telephone: +86-10-82265021 Fax: +86-10-82265021
Received: September 10, 2014
Peer-review started: September 11, 2014
First decision: October 14, 2014
Revised: October 24, 2014
Accepted: December 1, 2014
Article in press: December 1, 2014
Published online: March 7, 2015
Processing time: 180 Days and 5.1 Hours
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: Helicobacter pylori; Antibiotic resistance; Beijing; Dyspeptic symptoms

Core tip: Because the antimicrobial susceptibility of Helicobacter pylori (H. pylori) strains continues to change over time, it is very important to obtain updated information on antibiotic resistance by dynamic monitoring and serial detection, which is critical to the selection of the most optimal therapeutic regimens for eradication of H. pylori infection. This study provided us the comprehensive and up-to-date data about antibiotic resistance of H. pylori. It was showed that H. pylori resistance to commonly used antibiotics in China is high with increased multiple antibiotic resistances. Therefore, the eradication of H. pylori infection remains a challenge in China.