Primary Antibiotic Resistance of Helicobacter pylori in Different Regions of China: A Systematic Review and Meta-Analysis

Chen, Biaohua; Li, Puheng; Huang, Yu Chen; Guo, Yixian; Ding, Zhaohui; Lü, Hong

doi:10.3390/pathogens11070786

Cited by 36 publications

(41 citation statements)

References 62 publications

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“…Primary and secondary resistance to CLA, as well as to MTZ and LEV is higher than 15% in most WHO regions (6, 22). However, in Gipuzkoa, primary resistance to the three most commonly used antimicrobials for H. pylori infection was lower than that reported for other countries (22)(23)(24)(25). This could be, at least in part, due to the performing culture of H. pylori followed by antibiogram in all isolates obtained from biopsies, and accordingly prescribing an antibiogram-guided treatment.…”

Section: Discussioncontrasting

confidence: 55%

WITHDRAWN: Helicobacter pylori Primary and Secondary Antimicrobial Resistance through 22 Years of Culture Experience (2000-2021)

Arbulo

Tamayo

Bujanda

et al. 2022

Preprint

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Background Helicobacter pylori gastritis is considered to be an infectious disease, irrespective of an individual’s symptoms and stage of disease. Until now, most consensus recommendations were based on empirical treatments conditional on local antimicrobial susceptibility patterns. The aim of this study was to provide information about the primary and secondary antimicrobial resistance rates in Gipuzkoa, Basque Country, Spain, and to share the experience of H. pylori culture followed by susceptibility testing. Methods In total, 31,406 gastroduodenal biopsies and 2,641 string tests from patients over the age of 15 were plated on selective media, isolating H. pylori in 36.7% of biopsies and 50.7% of string tests. Antibiograms could be performed in 96.6% (12,399/12,835) of H pylori isolates. Overall, 10.8% (1,343/12,399) of antibiograms were obtained from second or subsequent samples from the same patient. PCRs were also used to detect H. pylori and its clarithromycin resistance. Results Primary resistance to amoxicillin and tetracycline was unusual, 0.6% and 0.2%, respectively. Primary resistances to clarithromycin and metronidazole remained constant through the 22-years of study, around 14% and 30% respectively. Primary resistance to levofloxacin tripled from 7.6% in 2000 to 21.7% in 2021 (p < 0.001) and grew with patient’s increasing age. Simultaneous resistance to clarithromycin, metronidazole and levofloxacin was 1.8%. Secondary resistance to all antimicrobials was significantly higher than primary resistance. Conclusion We encourage Microbiology laboratories to perform culture and/or PCR of H. pylori followed by antimicrobial susceptibility testing, allowing physicians to follow a tailored treatment strategy.

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Section: Discussioncontrasting

confidence: 55%

WITHDRAWN: Helicobacter pylori Primary and Secondary Antimicrobial Resistance through 22 Years of Culture Experience (2000-2021)

Arbulo

Tamayo

Bujanda

et al. 2022

Preprint

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“…Although the antibiotic combination partially improves the eradication rate, it is also associated with eradication failure. In China, the drug resistance rates of clarithromycin, metronidazole, and levofloxacin remain high [4] . Specifically, BQT is administered for 10 or 14 days.…”

Section: Introductionmentioning

confidence: 99%

Dual therapy for Helicobacter pylori infection

Duan

Liu

Zuo

2023

Chinese Medical Journal

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Bismuth-containing quadruple therapy (BQT) has long been recommended for Helicobacter pylori (H. pylori) eradication in China. Meanwhile, in the latest national consensus in China, dual therapy (DT) comprising an acid suppressor and amoxicillin has also been recommended. In recent years, the eradication rate of H. pylori has reached >90% using DT, which has been used not only as a first-line treatment but also as a rescue treatment. Compared with BQT, DT has great potential for H. pylori eradication; however, it has some limitations. This review summarizes the development of DT and its application in H. pylori eradication. The H. pylori eradication rates of DT were comparable to or even higher than those of BQT or standard triple therapy, especially in the first-line treatment. The incidence of adverse events associated with DT was lower than that with other therapies. Furthermore, there were no significant differences in the effects of dual and quadruple therapies on gastrointestinal microecology. In the short term, H. pylori eradication causes certain fluctuations in the gastrointestinal microbiota; however, in the long term, the gastrointestinal microbiota eventually returns to its normal state. In the penicillin-naïve population, patients receiving DT have a high eradiation rate, better compliance, lower incidence of adverse reactions, and lower primary and secondary resistance to amoxicillin. These findings suggest the safety, efficacy, and potential of DT for H. pylori eradication.

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“…The high prevalence of clarithromycin resistance limited the eradication effect [ 13 ]. A systematic review showed that clarithromycin resistance was up to 35% in southwestern China [ 48 ]. In our study, the eradication rate of polaprezinc-containing quadruple therapy was non-inferior to conventional bismuth-containing quadruple therapy (75.0% vs. 87.8%).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Quadruple Therapy with Polaprezinc or Bismuth on Gut Microbiota after Helicobacter pylori Eradication: A Randomized Controlled Trial

et al. 2022

JCM

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Background: Quadruple therapy with polaprezinc provided an alternative to Helicobacter pylori eradication; however, the effect on gut microbiota remains uncertain. This study aims to identify whether polaprezinc-containing quadruple therapy causes adverse microbiota effects among asymptomatic adults, compared with bismuth therapy. Methods: This was a randomized control trial. One hundred asymptomatic H. pylori-infected adults were randomly (1:1) assigned to two treatment groups (polaprezinc-containing therapy, PQT; or bismuth-containing therapy, BQT). Fecal samples were collected from subjects before and 4–8 weeks after therapy. Samples were sequenced for the V4 regions of the 16S rRNA gene. Results: The relative abundance of the three dominant bacterial phyla (Bacteroidota, Firmicutes, and Proteobacteria) accounted for more than 95% of each treatment group. The alpha diversity between eradications that succeeded and those that failed had no significant difference (p > 0.05). After successful eradication, the alpha diversity in the BQT group decreased in comparison with the baseline (p < 0.05). Subjects who were successfully eradicated by BQT showed considerably lower alpha diversity indices than those of the PQT at follow-up (p < 0.05). The abundance of Parasutterella in subjects who were successfully eradicated by PQT was four times greater than that of BQT (q < 0.05). Conclusion: A 14-day PQT may be superior to BQT in maintaining short-term gut microbiota homeostasis after H. pylori treatment. Our findings preliminarily provide evidence of the short-term impacts of the gut microbiota after PQT treatment of H. pylori infection.

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Primary Antibiotic Resistance of Helicobacter pylori in Different Regions of China: A Systematic Review and Meta-Analysis

Cited by 36 publications

References 62 publications

WITHDRAWN: Helicobacter pylori Primary and Secondary Antimicrobial Resistance through 22 Years of Culture Experience (2000-2021)

WITHDRAWN: Helicobacter pylori Primary and Secondary Antimicrobial Resistance through 22 Years of Culture Experience (2000-2021)

Dual therapy for Helicobacter pylori infection

The Effect of Quadruple Therapy with Polaprezinc or Bismuth on Gut Microbiota after Helicobacter pylori Eradication: A Randomized Controlled Trial

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