Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2021; 9(35): 10838-10849
Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.10838
Ninety-four thousand-case retrospective study on antibacterial drug resistance of Helicobacter pylori
Yu Zhang, Fei Meng, Jie Jin, Jun Wang, Bin-Bin Gu, Jin-Bang Peng, Li-Ping Ye
Yu Zhang, Jun Wang, Bin-Bin Gu, Jin-Bang Peng, Li-Ping Ye, Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, Linhai 318000, Zhejiang Province, China
Fei Meng, Jie Jin, Department of Research Service, Zhiyuan Medical Inspection Institute CO., LTD, Hangzhou 310030, Zhejiang Province, China
Li-Ping Ye, Department of Gastroenterology, Taizhou Hospital Affiliated to Wenzhou Medical University, Taizhou 318000, Zhejiang Province, China
Author contributions: Zhang Y and Ye LP formulated the problem; Meng F and Jin J performed the microbial culture and susceptibility testing; Wang J analyzed the data; Gu BB and Peng JB collected samples; Zhang Y and Ye LP wrote the paper; all authors read, reviewed and approved the manuscript.
Supported by Taizhou Science and Technology Plan Project, No. 1701KY20.
Institutional review board statement: The study was reviewed and approved by the ethics committee of Taizhou Hospital of Zhejiang Province.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Li-Ping Ye, PhD, Director, Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, No.150 Ximen Street, Linhai 318000, Zhejiang Province, China. 774201768@qq.com
Received: April 22, 2021
Peer-review started: April 22, 2021
First decision: May 24, 2021
Revised: June 1, 2021
Accepted: September 14, 2021
Article in press: September 14, 2021
Published online: December 16, 2021
Processing time: 231 Days and 23.8 Hours
Abstract
BACKGROUND

The resistance rate to antibacterial drugs is the key inhibitor of Helicobacter pylori (H. pylori) eradication treatment.

AIM

To evaluate the prevalence and drug resistance of H. pylori based on big data.

METHODS

Gastric mucosal specimens were collected from naive patients undergoing upper gastrointestinal endoscopy for H. pylori culture and antimicrobial susceptibility testing (AST), including clarithromycin, levofloxacin, metronidazole and amoxicillin. Every 10 years of age was grouped as an age group. The H. pylori infection and resistance were explored based on the age group and gender.

RESULTS

The number of H. pylori-positive specimen was 94509 in 283823 gastric mucosal specimens, with an infection rate of 33.30%. The infection rate increased with age, and males had a higher infection rate than females. The average resistance rate of H. pylori to amoxicillin and metronidazole was 0.21% and 93.72%, which remained stable. The average resistance rate to clarithromycin was 23.99% with an increasing trend from 14.43% to 38.24%. The average resistance rate to levofloxacin was 30.29%, which increased from 17.07% to 39.42% and mostly stabilized after 2017. The resistance rate of H. pylori increased with age, except amoxicillin. H. pylori in females are at higher risk of resistance to metronidazole, but not to amoxicillin, regardless of the age group. Meanwhile, H. pylori in females are at higher risk of resistance to levofloxacin and clarithromycin in the 21-50 age group. The single, dual, triple and quadruple-drug resistance rate was 54.59%, 29.03%, 11.71% and 0.11%, respectively.

CONCLUSION

The resistance of H. pylori in Taizhou city is serious. Guided by the consensus report, individualized treatment based on AST is recommended.

Keywords: Helicobacter pylori; Infection; Resistance; Age group; Gender

Core Tip: We shared a 10-year data in prevalence and resistance of Helicobacter pylori (H. pylori) in Taizhou city, Zhejiang province, China. We found that the infection rate increased with age, and males had a higher infection rate than females. The resistance rate of H. pylori to metronidazole, clarithromycin and levofloxacin was increased with age. H. pylori in females are at higher risk of resistance to metronidazole, but not to amoxicillin, regardless of the age group. Meanwhile, H. pylori in females are at higher risk of resistance to levofloxacin and clarithromycin in the 21-50 age group.