Affiliation:
1. Department of Gastroenterology, The First Affiliated Hospital Zhejiang University School of Medicine, Zhejiang University Hangzhou China
2. Zhiyuan Inspection Medical Institute Hangzhou China
3. Department of Gastroenterology Cangnan People's Hospital Wenzhou China
4. Department of Digestive Affiliated Children's Hospital of Jiangnan University Wuxi China
5. The Affiliated Wuxi People's Hospital of Nanjing Medical University Wuxi China
6. Children's Hospital Affiliated to Shandong University Jinan China
7. Department of Gastroenterology Children's Hospital of Chongqing Medical University Chongqing China
8. Department of Mathematics and Statistics Northern Arizona University Flagstaff Arizona USA
Abstract
AbstractBackgroundTo investigate the antibiotic resistance of Helicobacter pylori (H. pylori) strains to clarithromycin, metronidazole, amoxicillin, levofloxacin, furazolidone, and tetracycline in Chinese children.Materials and MethodsThis multicenter, retrospective study was conducted from January 2016 through May 2023. Gastric mucosa biopsies were obtained from pediatric participants who underwent upper gastrointestinal endoscopy at 96 hospitals in northern, southwestern, and southeastern China. The susceptibility of H. pylori to six commonly used antibiotics was determined by agar dilution method.ResultsAmong the 3074 H. pylori isolates, 36.7% were resistant to clarithromycin, 77.3% to metronidazole, 16.6% to levofloxacin, and 0.3% to amoxicillin. No strains were detected to be resistant to furazolidone or tetracycline. During the 8‐year study period, resistance to clarithromycin and metronidazole showed a significant upward trend, while the resistance pattern of the other antibiotics demonstrated a slight but nonsignificant fluctuation. Significant regional differences were found in the distribution of clarithromycin resistance among the northern (66.0%), southwestern (48.2%), and southeastern (34.6%) regions. The metronidazole resistance rate was significantly lower in the southeastern coastal region (76.3%) than in the other two regions (88.2% in the north and 87.7% in the southwest). Multi‐drug resistance for two or more antibiotics was detected in 36.3% of the H. pylori strains, and the predominant multi‐resistance pattern was the dual resistance to clarithromycin and metronidazole.ConclusionsThe prevalence of H. pylori resistance to clarithromycin and metronidazole is rather high in Chinese children and has been increasing over time. A relatively high resistance rate to levofloxacin was also noticed in children, while almost all strains were susceptible to amoxicillin, furazolidone, and tetracycline. It will be of great clinical significance to continuously monitor the antibiotic‐resistance patterns of H. pylori in the pediatric population.
Funder
National Natural Science Foundation of China
Natural Science Foundation of Zhejiang Province
Subject
Infectious Diseases,Gastroenterology,General Medicine