Clinical Resistance of Helicobacter pylori and Its Trend: A 10-year Data Analysis at Peking University People's Hospital

  Objective  To study the resistance of Helicobacter pylori(Hp) isolated from Peking University People's Hospital to commonly used antibiotics, in order to provide basis for clinical rational drug use.

  Methods  The drug susceptibility test data of Hp strains isolated from gastric mucosal biopsy specimens of outpatients in the Department of Gastroenterology, Peking University People's Hospital from May 2011 to December 2021 were retrospectively collected. The drug resistance rate and dual/multiple drug resistance of Hp to amoxicillin, metronidazole, clarithromycin, levofloxacin and tetracycline were statistically analyzed.

  Results  A total of 120 Hp strains isolated from 402 gastric mucosa specimens (120 patients) and cultured positive were included, with a culture positive rate of 29.85%. The resistance rates of Hp to metronidazole (75.0%) and clarithromycin (72.5%) were relatively high, while the resistance rates to levofloxacin (45.8%), amoxicillin (12.5%) and tetracycline (4.2%) were relatively low. The drug resistance of Hp to clarithromycin and amoxicillin was not significantly affected by the age of the patients. The drug resistance rate to metronidazole and levofloxacin increased with the age of the patients, and the drug resistance rate to tetracycline decreased with the age of the patients. The resistance rate of female patients to levofloxacin was higher than that of male patients (56.7% vs. 32.1%, P=0.007). Over time, the resistance rate of Hp to clarithromycin increased gradually, the resistance rate to levofloxacin increased first and then decreased, the resistance rate to metronidazole fluctuated and was high overall, and the resistance rate to amoxicillin and tetracycline was not significantly affected by time and was relatively low overall. No Hp strains resistant to all five kinds of antibiotics were found. Dual drug resistance rate was 25.0%, with the simultaneous resistance of metronidazole and clarithromycin being the most common (20.0%); multiple drug resistance rate was 44.2%, with the simultaneous resistance of metronidazole + clarithromycin + levofloxacin being the most common (32.5%).

  Conclusions  The resistance rate of Hp strains isolated from Peking University People's Hospital to metronidazole, clarithromycin and levofloxacin is high, and multiple drug resistance is serious. When carrying out empirical Hp root therapy in clinic, the drug regimen should be reasonably selected, and drug sensitivity test should be conducted when necessary, so as to guide the formulation of treatment regimen.