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Antibiotic resistance of Helicobacter pylori isolated from children in Chongqing, China

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A Correction to this article was published on 21 October 2022

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Abstract

The resistance of Helicobacter pylori (H. pylori) to antibiotics has been increasing worldwide and varies across different geographic areas and times. Limited studies reported the prevalence of antibiotic resistance and its related gene mutations in children in Chongqing, a city located in southwest China. We collected 112 H. pylori strains isolated from gastric biopsies of 156 children at Children’s Hospital of Chongqing Medical University and calculated resistance rates of these strains to six antibiotics. The A2143G and A2142G mutations in 23S rRNA gene, which are related to clarithromycin resistance, and Asn87 and Asp91 mutations in gyrA gene, which are related to levofloxacin resistance, were investigated in 102 strains. The resistance rates to clarithromycin, metronidazole, and levofloxacin were 47.3% (53/112), 88.4% (99/112), and 18.8% (21/112), respectively. No resistance to amoxicillin, tetracycline, and furazolidone was observed. Dual and triple resistance percentages were 37.5% (42/112) and 10.7% (12/112), respectively. The detection rate of A2143G mutation in 23S rRNA gene was 83.3% (40/48). The detection rates of mutations of Asn87 and Asp91 in gyrA gene were 52.6% (10/19) and 36.8% (7/19), respectively.

Conclusion: The prevalence of H. pylori resistance to clarithromycin, metronidazole, and levofloxacin was high in children in Chongqing, China. The A2143G mutation was detected in most clarithromycin-resistant strains, and Asn87 and Asp91 of gyrA mutation points were common in levofloxacin-resistant strains. In clinical practice, anti-H. pylori therapy should be individualized based on a susceptibility test. 

What is Known:

• The resistance of H. pylori to antibiotics changes with the geographic areas and that in Asia the resistance rate is high.

• Mutation plays a vital role in antibiotics resistance of H. pylori.

What is New:

• High resistance rates to single and multiple antibiotics in children of Chongqing, a city located in southwest China, were observed.

• Molecular assays showed good conformance with susceptibility test results to direct antibiotic resistance of H. pylori.

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Data availability

The raw data supporting the conclusions of this article will be made available by the authors without undue reservation.

Change history

Abbreviations

AMO:

Amoxicillin

CLA:

Clarithromycin

FUR:

Furazolidone

LEV:

Levofloxacin

MTZ:

Metronidazole

NUD:

Non-ulcer disease

PUD:

Peptic ulcer diseases

PPI:

Proton pump inhibitor

TET:

Tetracycline

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Funding

This study was supported by the Science and Health Joint Medical Research Program of Chongqing (2019ZDXM045).

Author information

Authors and Affiliations

  1. Department of Gastroenterology, National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, No. 136, 2nd Zhongshan Road, Yuzhong District, Chongqing, People’s Republic of China

    Tian Geng, Zhong-Su Yu, Xi-Xi Zhou, Bo Liu, Hui-Hua Zhang & Zhong-Yue Li

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  1. Tian Geng
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Contributions

Tian Geng and Zhong-Su Yu conceived and designed the experiments, collected materials, analyzed and interpreted the data, drafted the manuscript. Xi-Xi Zhou, Hui-Hua Zhang, Bo Liu conceived and designed the experiments, collected materials. Zhong-Yue Li conceived and designed the experiments, analyzed and interpreted the data, drafted and revised the manuscript, and approved the final version.

Corresponding author

Correspondence to Zhong-Yue Li.

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Ethics approval

This study was approved by the Ethics Committee of Children’s Hospital of Chongqing Medical University (File No. 2017–36-1) and informed consent of the clinical trial was signed from legal guardians of the whole subjects.

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All participants gave their written consent to participate.

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The authors declare no competing interests.

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Communicated by Peter de Winter

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The original online version of this article was revised: the abbreviation for Metronidazole in the Tables 2, 3 and 5 has been corrected to MTZ.

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Geng, T., Yu, ZS., Zhou, XX. et al. Antibiotic resistance of Helicobacter pylori isolated from children in Chongqing, China. Eur J Pediatr 181, 2715–2722 (2022). https://doi.org/10.1007/s00431-022-04456-1

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