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Helicobacter Pylori Prevalence and Antibiotic Resistance in Jiangsu Province, China Using the Fecal Test Coupled with MALDI-TOF Mass Spectrometry
Background and Purpose: Helicobacter pylori (H. pylori) infection demonstrates substantial epidemiological variations across populations and geographical regions. This multicenter study aimed to assess the prevalence of H. pylori infection and characterize antibiotic resistance patterns among residents of 13 cities in Jiangsu Province, China.
Methods: We conducted a population-based cross-sectional study enrolling randomly sampled households across participating cities, with only one member enrolled per household. Fecal specimens were analyzed using fluorescence quantitative PCR melting curve analysis coupled with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) to determine H. pylori infection status and antibiotic resistance profiles.
Results: The final cohort comprised 6,113 participants, including 5,302 adults (86.7%) and 811 children (13.3%, aged <18 years). Adult populations exhibited significantly higher H. pylori infection rates compared to the children (34.89% [1,850/5,302] vs 15.54% [126/811]; P < 0.001). Age-stratified analysis revealed peak prevalence in middle-aged populations (40-69 years: 37.49% [1,209/3,225]; P < 0.001). Antimicrobial resistance profiling demonstrated concerning patterns in adults: fluoroquinolone resistance (43.68%), clarithromycin resistance (53.51%), furazolidone resistance (14.11%), and amoxicillin resistance (14.11%). Isolates in children showed lower resistance rates: fluoroquinolones (26.19%), clarithromycin (46.83%), and furazolidone (4.76%). Resistance to amoxicillin and tetracycline was not found in children as well as resistance to tetracycline in adults. Antibiotic resistance of H. pylori for fluoroquinolones and clarithromycin was relatively high in adults, reaching 43.68% and 53.51%, respectively. Resistance to furazolidone, amoxicillin, and tetracycline was relatively low in adults.
Conclusions: Our findings reveal substantial burdens of H. pylori infection across all age groups in Jiangsu Province, with particularly high resistance rates to first-line antibiotics (fluoroquinolones and clarithromycin) in adult populations. These results underscore the urgent need for resistance-guided treatment strategies and emphasize the importance of ongoing antimicrobial stewardship programs in clinical practice.
Keywords: Helicobacter pylori, Prevalence, antibiotic resistance, adults, children
Wang, Shukui and Sun, Huiling and Peng, Ruolin and Zhang, Luyao and Zhang, Zhimei and Yang, Chuchu and Xu, Zhengyuan and Wang, Jiabin and Chen, Guangxia and Zhao, Xinxin and Ye, Xiaofeng and Shen, Lu and Xu, Chunyan and Du, Jing and Cui, Jianhua and Chen, Lin and Zhan, Qiang and Din, Lijia and Lu, Cuihua and Chen, Hao and Wang, Jun and Ou, Rong and Tao, Jian and Xi, Meijuan and Xu, Lamei and Xu, Min and Duan, Zhaotao and Gao, Xuefeng and Chen, Lei and Gao, Sujun and Xu, Xiaodan and Zhang, Gongyu and Li, Xiangsu and Wu, Xudong and Xu, Weibing and Hong, Jiawen and He, Bangshun and Zhang, Zhenyu, Helicobacter Pylori Prevalence and Antibiotic Resistance in Jiangsu Province, China Using the Fecal Test Coupled with MALDI-TOF Mass Spectrometry. Available at SSRN: https://ssrn.com/abstract=5181683 or http://dx.doi.org/10.2139/ssrn.5181683
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