Antibiotic Resistance Profile Of Helicobacter Pylori :A Single-center Study

Objective:To investigate the drug-resistance of Helicobacter pylori(H.Pylori)in Fujian Province.Methods :The bacteria were isolated,cultured and identified from the biopsy samples of gastric mucosae of which patients came to examine with gastroscopy from March 2018 to December 2018 in Fujian Provincial Hospital.Antimicrobial susceptibility test was performed by breakpoint susceptibility test for H.pylori strains to 12 antibiotics,amoxicillin(AMX),clarithromycin(CLR),levofloxacin(LVFX),metronidazole(MTZ),furazolidone(FZD),Amoxicillin potassium clavulanate(AMC),cefixime(CFM),gentamicin(GEN),azithromycin(AZM),sparfloxacin(SPFX),tinidazole(TID)and rifampicin(RFP).The minimal inhibitory concentration(MIC)of 7 different antibiotics(AMX,CLR,MTZ,FZD,LVFX,CFM,Tetracycline(TET))is determined by microdilution broth method,and ATCC standard strain served as a control.Results :A total of 106 H.Pylori strains were successfully isolated from the biopsy samples of gastric mucosae.The drug resistance rate against MTZ,CLR,AZM,AMX,LVFX,FZD,AMC,CFM,GEN,SPFX,TID,RFP is 20.75,13.21,11.32,7.55,8.49,2.83,4.72,4.72,6.60,10.38,10.38 and 0.94%,respectively.The rates of single resistance,double resistance and multiple resistance in commonly used antibiotics,were 12.3%,12.3% and 4.7%,respectively.There were no significant statistical differences of H.Pylori resistance among different genders,ages and diseases(P >0.05).16 H.Pylori strains were isolated to measure the MICs for different drugs: AMX: 0.0156?g/ml ~ 8?g/ml(ATCC= 0.25?g/ml),CLR: 0.0156?g/ml ~ 64?g/ml(ATCC= 0.0625?g/ml),MTZ: 0.125?g/ml ~ 128?g/ml(ATCC= 64?g/ml),FZD: 0.03125?g/ml ~ 64?g/ml(ATCC= 0.25?g/ml),LVFX: 0.0156?g/ml ~ 128?g/ml(ATCC= 0.5?g/ml),CFM: 0.125?g/ml ~ 8?g/ml(ATCC= 0.25?g/ml),TET: 0.0156?g/ml ~ 1?g/ml(ATCC= 0.25?g/ml).Differences in resistance rates by the two breakpoints affected the results for all tested antibiotics(P<0.05).Conclusions : In Fujian Province,the prevalence of H.Pylori resistance among commonly used antibiotics to MTZ,CLR and LVFX is high,while the prevalence to AMX and FZD is relatively low.In the other eradication regimens,the drug resistance rate against AMC,CFM,GEM and RFP is in the low level.H.Pylori eradication therapy should be individualized according to the results of susceptibility test.