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Helicobacter Pylori Prevalence And Antibiotic Resistance in Jiangsu Province, China Using the Fecal Test Coupled with MALDI-TOF Mass Spectrometry
32 Pages Posted: 14 Apr 2025
More...Abstract
Importance: The prevalence of Helicobacter pylori (H. pylori) infection suggested a significant unbalance between different populations and geographic areas.
Objective: To investigate the prevalence of H. pylori infection and antibiotic resistance across 13 cities in Jiangsu province, China.
Design: A prospective, multicenter, and cross-sectional study was performed to portray the profile of H. pylori and its antibiotic resistance rates in Jiangsu province from March 2023 to March 2024.
Setting: This is a prospective, multicenter, and cross-sectional study.
Participants: This study enrolled adults and children from random sampling of households according each city, which only included one family member from every family.
Exposure: The prevalence of H. pylori infection and antibiotic resistance across Jiangsu province.
Main Outcomes and Measures: The primary outcome was the prevalence of H. pylori infection. Fecal samples were detected by the fluorescent polymerase chain reaction (PCR) melting curve method and matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) to know H. pylori infection and antibiotic resistance.
Results: A total of 6113 participants were enrolled in the final analysis. Of them, 5302 (86.73%) were adults, and 811 (13.27%) were children (aged <18 years). A total of 1850 (34.89%) was infected with H. pylori in adults, which was significantly higher than that in children (15.54%, 126/811) (P<0.001). An unbalanced prevalence of H. pylori infection was observed among different age group, with the highest prevalence in those aged between 40 and 69 years (37.49%, 1209/3225) (P<0.001). H. pylori resistance rates of 43.68%, 53.51%, and 14.11% were measured for fluroquinolones, clarithromycin, furazolidone, and amoxicillin in adults, respectively, as well as 26.19% for fluroquinolones, 46.83% for clarithromycin, and 4.76% for furazolidone in children. 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 and Relevance: H. pylori infection rate is high in adults and children in Jiangsu province. Resistance to primary antibiotics warrants attention, especially for fluoroquinolones and clarithromycin in adults.
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