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

doi:10.3748/wjg.v21.i9.2786

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Prospective Study

World J Gastroenterol. Mar 7, 2015; 21(9): 2786-2792
Published online Mar 7, 2015. doi: 10.3748/wjg.v21.i9.2786

Table 1 Characteristics of the patients with Helicobacter pylori positive culture

Characteristic	2009-2010(n = 371)	2013-2014(n = 950)	P value
Gender (male/female), n	185/186	485/465	0.698
Age (yr), mean ± SD	41.9 ± 13.4	42.9 ± 13.2	0.215
Endoscopic findings, n
Peptic ulcer	60	184	0.320
Gastric erosions	75	200
No macroscopic abnormality	236	566
Histological findings, n
Non-atrophic gastritis	245	664	0.174
Atrophic gastritis	126	286	0.174

Table 2 Multiple resistance patterns in the Helicobacter pylori isolates n (%)

Multiple resistance pattern	2009-2010(n = 371)	2013-2014(n = 950)
Double resistance
CLA + MTZ	36 (9.7)	79 (8.3)
MTZ + LEV	29 (7.8)	94 (9.9)
MTZ + RIF	15 (4.0)	14 (1.5)
CLA + LEV	13 (3.5)	40 (4.2)
AMX + MTZ	3 (0.8)	3 (0.3)
MTZ + TET	3 (0.8)	2 (0.2)
CLA + RIF	2 (0.5)	11 (1.2)
AMX + CLA	2 (0.5)	4 (0.4)
CLA + TET	1 (0.3)	5 (0.5)
AMX + RIF	1 (0.3)	2 (0.2)
LEV + RIF	0	8 (0.8)
LEV + TET	0	5 (0.5)
AMX + LEV	0	1 (0.1)
Triple resistance
CLA + MTZ + LEV	34 (9.2)	171 (18.0)
CLA + MTZ + RIF	7 (1.9)	16 (1.7)
AMX + CLA + MTZ	6 (1.6)	4 (0.4)
MTZ + LEV + RIF	4 (1.1)	18 (1.9)
CLA + MTZ + TET	4 (1.1)	1 (0.1)
CLA + LEV + RIF	2 (0.5)	11 (1.2)
AMX + MTZ + LEV	2 (0.5)	2 (0.2)
AMX + MTZ + RIF	1 (0.3)	0
AMX + CLA + LEV	1 (0.3)	0
CLA + LEV + TET	1 (0.3)	3 (0.3)
MTZ + LEV + TET	0	10 (1.1)
AMX + CLA + RIF	0	1 (0.1)
CLA + TET + RIF	0	1 (0.1)
MTZ + TET + RIF	0	1 (0.1)
Quadruple resistance
CLA + MTZ + LEV + RIF	12 (3.2)	38 (4.0)
AMX + CLA + MTZ + LEV	4 (1.1)	9 (0.9)
CLA + MTZ + LEV + TET	4 (1.1)	8 (0.8)
MTZ + LEV + TET + RIF	1 (0.3)	8 (0.8)
AMX + MTZ + LEV + TET	1 (0.3)	0
AMX + MTZ + LEV + RIF	1 (0.3)	0
AMX + CLA + MTZ + RIF	0	3 (0.3)
CLA + MTZ + TET + RIF	0	2 (0.2)
CLA + LEV + TET + RIF	0	1 (0.1)
Quintuple resistance
CLA + MTZ + LEV + TET + RIF	1 (0.3)	17 (1.8)
AMX + CLA + MTZ + LEV + RIF	0	3 (0.3)
AMX + CLA + MTZ + LEV + TET	0	2 (0.2)
Sextuple resistance	1 (0.3)	1 (0.1)

AMX: Amoxicillin; CLA: Clarithromycin; LEV: Levofloxacin; MTZ: Metronidazole; RIF: Rifampicin; TET: Tetracycline.

Table 3 Influencing factors of antibiotic resistance of Helicobacter pylori isolates

Resistance rate (%)	GenderMale (n = 670),female (n = 651)	Age (yr)18-35 (n = 496),36-50 (n = 378),51-75 (n = 447)	Endoscopic findingsPUD (n = 244),NUD (n = 1077)
Amoxicillin	5.1, 5.1	4.2, 5.3, 5.8	2.9, 5.6
Clarithromycin	46.6, 51.6	50.8, 48.7, 47.4	36.5, 51.9^a (OR = 1.822; 95%CI: 1.364-2.433)
Metronidazole	59.4, 69.4^a (OR =1.504; 95%CI: 1.195-1.891)	63.3, 62.2, 67.3	58.6, 65.6
Levofloxacin	43.6, 54.8^a (OR =1.518; 95%CI: 1.219-1.891)	42.9, 53.4, 52.3^a (OR =1.199; 95%CI: 1.053-1.365)	45.1, 50.0
Tetracycline	7.2, 6.0	6.7, 4.5, 8.3	6.1, 6.7
Rifampicin	19.0, 15.8	16.7, 16.9, 18.6	20.9, 16.6

^aP < 0.05, the significant difference in levofloxacin resistence rate was observed among different age groups. PUD: Peptic ulcer disease; NUD: Non-ulcer disease; OR: Odds ratio; CI: Confidence interval.

Citation: Zhang YX, Zhou LY, Song ZQ, Zhang JZ, He LH, Ding Y. Primary antibiotic resistance of Helicobacter pylori strains isolated from patients with dyspeptic symptoms in Beijing: A prospective serial study. World J Gastroenterol 2015; 21(9): 2786-2792
URL: https://www.wjgnet.com/1007-9327/full/v21/i9/2786.htm
DOI: https://dx.doi.org/10.3748/wjg.v21.i9.2786