ArticlePloS one2016
Surveillance of Helicobacter pylori Antibiotic Susceptibility in Indonesia: Different Resistance Types among Regions and with Novel Genetic Mutations.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- The prevalence of clarithromycin-resistantPeerJ · 2023Pooled it
- Clinical relevance of the cagA and vacA s1m1 status and antibiotic resistance in Helicobacter pylori: a systematic review and meta-analysis.BMC infectious diseases · 2022Pooled it
- Management of Helicobacter pylori treatment failures: A large population-based study (HP treatment failures trial).PloS one · 2023Trial
- Comparison of 10-Day Course of Triple Therapy Versus 14-Day Course for Eradication of Helicobacter pylori Infection in an Indonesian Population: Double-Blinded Randomized Clinical Trial.Asian Pacific journal of cancer prevention : APJCP · 2020Trial
- Computational Screening of Selected Phytochemicals Against Levofloxacin and Metronidazole-Resistant IndonesianMicroorganisms · 2026Article
- Effects of Lactobacillus spp. on Helicobacter pylori: A Promising Frontier in the Era of Antibiotic Resistance.Probiotics and antimicrobial proteins · 2025Review
- Analysis of antibiotic susceptibility and genomic characteristics of Helicobacter pylori by whole-genome resequencing in Northern China.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2025Article
- Biofilm ofAntibiotics (Basel, Switzerland) · 2023Review
- Antibiotic Resistance, Susceptibility Testing and Stewardship inInternational journal of molecular sciences · 2023Review
- Global Antimicrobial Resistance Gene Study ofAntibiotics (Basel, Switzerland) · 2023Article
- Management of dyspepsia and Helicobacter pylori infection: the 2022 Indonesian Consensus Report.Gut pathogens · 2023Review
- Article
- Assessment of Helicobacter pylori positive infected patients according to Clarithromycin resistant 23S rRNA, rpl22 associated mutations and cyp2c19*1, *2, *3 genes pattern in the Early stage of Gastritis.BMC research notes · 2022Article
- Helicobacter pylori Infection, Its Laboratory Diagnosis, and Antimicrobial Resistance: a Perspective of Clinical Relevance.Clinical microbiology reviews · 2022Review
- Biomarker Characterization and Prediction of Virulence and Antibiotic Resistance fromBiomolecules · 2022Review
- Antimicrobial resistance patterns and genetic elements associated with the antibiotic resistance of Helicobacter pylori strains from Shanghai.Gut pathogens · 2022Article
- Next-Generation Sequencing-Based Study ofMicroorganisms · 2022Article
- Prevalence of antibiotic resistance ofAmerican journal of translational research · 2022Article
- Serum pepsinogen level as a biomarker for atrophy, reflux esophagitis, and gastric cancer screening in Indonesia.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2022Article
- Overview ofGut and liver · 2021Review
Corrections and comments
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Authors and funding
24 authors at 9 institutions in 3 countries.
Funding
Abstract
Information regarding Helicobacter pylori antibiotic resistance in Indonesia was previously inadequate. We assessed antibiotic susceptibility for H. pylori in Indonesia, and determined the association between virulence genes or genetic mutations and antibiotic resistance. We recruited 849 dyspeptic patients who underwent endoscopy in 11 cities in Indonesia. E-test was used to determine the minimum inhibitory concentration of five antibiotics. PCR-based sequencing assessed mutations in 23S rRNA, rdxA, gyrA, gyrB, and virulence genes. Next generation sequencing was used to obtain full-length sequences of 23S rRNA, infB, and rpl22. We cultured 77 strains and identified 9.1% with clarithromycin resistance. Low prevalence was also found for amoxicillin and tetracycline resistance (5.2% and 2.6%, respectively). In contrast, high resistance rates to metronidazole (46.7%) and levofloxacin (31.2%) were demonstrated. Strains isolated from Sumatera Island had significantly higher metronidazole resistance than those from other locations. Metronidazole resistant strains had highly distributed rdxA amino acid substitutions and the 23S rRNA A2143G mutation was associated with clarithromycin resistance (42.9%). However, one strain with the highest MIC value had a novel mutation in rpl22 without an A2143G mutation. Mutation at Asn-87 and/or Asp-91 of gyrA was associated with levofloxacin-resistance and was related to gyrB mutations. In conclusions, although this is a pilot study for a larger survey, our current data show that Indonesian strains had the high prevalence of metronidazole and levofloxacin resistance with low prevalence of clarithromycin, amoxicillin, and tetracycline resistance. Nevertheless, clarithromycin- or metronidazole-based triple therapy should be administered with caution in some regions of Indonesia.
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Registered trials
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