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Du LM, Hu SJ, Chen XM, Deng YY, Yong HL, Shi RC, Liu JG, Cao ZZ, You YJ, Liu YX, Ma SC, Ma LK, Li XF, Li XM, Hou JB, Ye ZC, Sang T, Cao Y, Liu H, Wei XX, Hu AL, Li YL, Gao HJ. [Survey of Helicobacter pylori levofloxacin and clarithromycin resistance rates and drug resistance genes in Ningxia, 2020-2022]. Zhonghua Yi Xue Za Zhi 2023; 103:2163-2167. [PMID: 37482728 DOI: 10.3760/cma.j.cn112137-20230214-00206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Objective: To explore the rate of Helicobacter pylori (Hp) resistance to levofloxacin and clarithromycin and the common mutation patterns of resistance genes in Ningxia, and to assess the concordance between phenotypic resistance and genotypic resistance. Methods: Cross-sectional study. Patients diagnosed with Hp infection in 14 hospitals in Ningxia region from February 2020 to May 2022 were retrospectively selected. Hp strains were isolated from gastric biopsy specimens of Hp-infected patients and subjected to phenotypic drug sensitivity testing and detection of resistance genes to analyze the rate of Hp resistance to levofloxacin and clarithromycin and the common mutation patterns of resistance genes in Ningxia region; and the concordance rate and Kappa concordance test were used to assess the concordance between phenotypic resistance and genotypic resistance. Results: A total of 1 942 Hp strains were isolated and cultured, and among the infections, 1 069 cases (55.0%) were male and 873 cases (45.0%) were female, aged (50.0±12.5) years (15-86 years). The rates of Hp resistance to levofloxacin and clarithromycin in Ningxia were 42.1% (818/1 942) and 40.1% (779/1 942), respectively, and the rate of dual resistance to both was 22.8% (443/1 942). The rate of resistance to levofloxacin and clarithromycin of Hp strains from female patients was higher than in male patients (levofloxacin: 50.4%(440/873) vs 35.4%(378/1 069); clarithromycin: 44.4%(388/873) vs 36.6%(391/1 069), both P<0.001). Among the GyrA gene mutations associated with levofloxacin resistance, the differences in mutation rate of amino acid at positions 87 and 91 were statistically significant in both drug-resistant and sensitive strains(both P<0.001), except for Asn87Thr. Hp strains were statistically significant for levofloxacin (Kappa=0.834, P<0.001) and clarithromycin (Kappa=0.829, P<0.001) had good concordance in resistance at the phenotypic and genotypic levels. Conclusion: The resistance of Hp to levofloxacin and clarithromycin in Ningxia region is severe, and there is good consistency between genotypic and phenotypic resistance.
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Affiliation(s)
- L M Du
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - S J Hu
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - X M Chen
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - Y Y Deng
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - H L Yong
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - R C Shi
- Department of Gastroenterology, Wuzhong People's Hospital, Wuzhong 751199, China
| | - J G Liu
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - Z Z Cao
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - Y J You
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - Y X Liu
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - S C Ma
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - L K Ma
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - X F Li
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - X M Li
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - J B Hou
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - Z C Ye
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - T Sang
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - Y Cao
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - H Liu
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - X X Wei
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - A L Hu
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - Y L Li
- Department of Gastroenterology, the Third Clinical Medical College of Ningxia Medical University, Ningxia Hui Autonomous Region People's Hospital, Yinchuan 750002, China
| | - H J Gao
- Department of Gastroenterology, Tongji Hospital, Tongji University, Institute of Digestive Disease, School of Medicine, Tongji University, Shanghai 200120, China
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