ArticleScientific reports2025
Helicobacter pylori antimicrobial resistance and gene variants in Shandong Province.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Eradication of Helicobacter pylori With Vonoprazan-Amoxicillin Dual Therapy as an Alternative for Bismuth-Based Quadruple Therapy: A Systematic Review and Noninferiority Meta-Analysis.Journal of gastroenterology and hepatology · 2026Pooled it
- Review
- Association of Resistance-AssociatedAntibiotics (Basel, Switzerland) · 2026Article
- Characterizing the profile transformation of Helicobacter pylori: increased secondary and multidrug resistance following failed eradication in Ningxia, China.BMC microbiology · 2026Article
- Antimicrobial Resistance Patterns and Predictors inMicroorganisms · 2026Article
- Genomic landscape and fine-scale population structure of Helicobacter pylori across China.Biomarker research · 2026Article
- Antibiotic resistance and associated gene mutations ofFrontiers in cellular and infection microbiology · 2026Article
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Authors and funding
13 authors.
Funding
Abstract
The emergence of antibiotic resistance in Helicobacter pylori led to a sharp decline in eradication rates, but there are limited data regarding the prevalence and genetic mechanisms of antibiotic resistance in Shandong. This study aims to assess the prevalence and molecular mechanisms of H. pylori antibiotic resistance to commonly used antibiotics in Shandong populations. Antimicrobial susceptibility testing was performed for clarithromycin, levofloxacin, metronidazole, tetracycline, rifampicin, amoxicillin, azithromycin, and moxifloxacin using E-test method. PCR amplified resistance-associated genes for all the strains, and 32 were whole-genome sequenced. 62 H. pylori strains were obtained and the infection rate was 30.1% (62/206). No resistance to amoxicillin was observed. Two and four strains were resistant to tetracycline and rifampicin, respectively, and no resistance-associated mutations were found in the 16S rRNA and rpoB genes. The resistance rates of azithromycin, clarithromycin, levofloxacin, and moxifloxacin were 56.45% (35/62), 33.87% (21/62), 48.39% (30/62), and 56.45% (35/62), respectively. The percentages of dual, triple, and quadruple resistance were 32.26% (20/62), 24.19% (15/62), and 1.61% (1/62), respectively, and only one isolate was resistant to quadruple antibiotics. Phenotypic resistance associated with the A2143G mutations in 23S rRNA for azithromycin and clarithromycin (kappa coefficient, 0.808 and 0.671, respectively), and gyrA mutations (N87K/N87I/D91G/D91Y/D91N) for levofloxacin and moxifloxacin (kappa coefficient, 0.526 and 0.442, respectively). Metronidazole resistance was observed in 43.55% (27/62) isolates and most of the metronidazole-resistant strains had truncated rdxA and frxA. The detection of a truncated rdxA gene correlated with phenotypic resistance results (kappa coefficient, 0.728). There was no association between whole-genome phylogeny and antibiotic resistance profiles. Our results revealed the high resistance rates and multiple resistance of H. pylori to commonly used antibiotics. Continued surveillance of H. pylori antibiotic resistance is crucial in Shandong to establish effective eradication therapy for this population.
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