Primary Antibiotic Resistance of in Different Regions of China: A Systematic Review and Meta-Analysis

Overview

Journal Pathogens

Date 2022 Jul 27

PMID 35890031

Authors

Jinnan Chen

Puheng Li

Yu Huang

Yixian Guo

Zhaohui Ding

Hong Lu

Affiliations

Soon will be listed here.

Abstract

Aim: Understanding the prevalence of antibiotic resistance can provide reliable information for selecting treatment options. The goal of this meta-analysis was to observe the primary antibiotic resistance of () in different regions and time periods of China.

Method: We searched PubMed, EMBASE, Chinese Biomedical databases and the China National Knowledge Infrastructure from inception to 20 February 2022. Data on the prevalence of primary resistance at various time points were included. A random-effect model was established to calculate the pooled antibiotic resistance.

Results: In total, 2150 articles were searched, with 70 meeting the inclusion criteria. The resistance to clarithromycin, metronidazole, levofloxacin amoxicillin, tetracycline and furazolidone in 2016-2020 were 34% (95% CI: 30-39%), 78% (95% CI: 73-84%), 35% (95% CI: 30-40%), 3% (95% CI: 1-5%), 2% (95%CI: 1-4%) and 1% (95% CI: 0-4%), respectively. Clarithromycin showed regional difference, as the resistance was higher in northern (37%, 95% CI: 32-41%) and western China (35%, 95% CI: 17-54%) than that in southern (24%, 95% CI: 17-32%) and eastern China (24%, 95% CI: 20-28%).

Conclusion: The resistance of to clarithromycin and metronidazole was high and increased over time, whereas resistance to levofloxacin, amoxicillin, tetracycline and furazolidone remained stable.

Citing Articles

Multiplex PCR-Mass Spectrometry Mini-Sequencing Technology Detected Antibiotic Resistance of to Six Antibiotics.

Zhao F, Zhao X, Zhang H, He L, Meng F, Zhang J Int J Mol Sci. 2025; 26(4).

PMID: 40004094 PMC: 11855914. DOI: 10.3390/ijms26041632.

Targeting Through the "Muco-Microbiotic Layer" Lens: The Challenge of Probiotics and Microbiota Nanovesicles.

Manna O, Caruso Bavisotto C, Gratie M, Damiani P, Bonaventura G, Cappello F Nutrients. 2025; 17(3).

PMID: 39940427 PMC: 11819664. DOI: 10.3390/nu17030569.

Gastric cancer prevention by community eradication of Helicobacter pylori: a cluster-randomized controlled trial.

Pan K, Li W, Zhang L, Liu W, Ma J, Zhang Y Nat Med. 2024; 30(11):3250-3260.

PMID: 39079993 DOI: 10.1038/s41591-024-03153-w.

Simultaneous Detection of and Clarithromycin Resistance Mutations Using RAA-CRISPR/Cas13a Assay.

Yan K, Wang X, Han Y, Tian Y, Niu M, Dong X Infect Drug Resist. 2024; 17:3001-3010.

PMID: 39045109 PMC: 11265216. DOI: 10.2147/IDR.S462963.

Novel therapeutic regimens against : an updated systematic review.

Huang T, Cao Y, Cao L Front Microbiol. 2024; 15:1418129.

PMID: 38912349 PMC: 11190606. DOI: 10.3389/fmicb.2024.1418129.

References

Su J, Zhou X, Chen H, Hao B, Zhang W, Zhang G . Efficacy of 1st-line bismuth-containing quadruple therapies with levofloxacin or clarithromycin for the eradication of Helicobacter pylori infection: A 1-week, open-label, randomized trial. Medicine (Baltimore). 2017; 96(7):e5859. PMC: 5319494. DOI: 10.1097/MD.0000000000005859. View

Song Z, Suo B, Zhang L, Zhou L . Rabeprazole, Minocycline, Amoxicillin, and Bismuth as First-Line and Second-Line Regimens for Helicobacter pylori Eradication. Helicobacter. 2016; 21(6):462-470. DOI: 10.1111/hel.12313. View

Megraud F, Bruyndonckx R, Coenen S, Wittkop L, Huang T, Hoebeke M . resistance to antibiotics in Europe in 2018 and its relationship to antibiotic consumption in the community. Gut. 2021; 70(10):1815-1822. DOI: 10.1136/gutjnl-2021-324032. View

Song Z, Zhou L, Zhang J, He L, Bai P, Xue Y . Hybrid Therapy as First-Line Regimen for Helicobacter pylori Eradication in Populations with High Antibiotic Resistance Rates. Helicobacter. 2016; 21(5):382-8. DOI: 10.1111/hel.12294. View

Zhou L, Zhang J, Chen M, Hou X, Li Z, Song Z . A comparative study of sequential therapy and standard triple therapy for Helicobacter pylori infection: a randomized multicenter trial. Am J Gastroenterol. 2014; 109(4):535-41. DOI: 10.1038/ajg.2014.26. View

Chen J, Huang Y, Ding Z, Liang X, Lu H . -Test or Agar Dilution for Metronidazole Susceptibility Testing of : Importance of the Prevalence of Metronidazole Resistance. Front Microbiol. 2022; 13:801537. PMC: 8964178. DOI: 10.3389/fmicb.2022.801537. View

Hong J, Shu X, Liu D, Zhu Y, Xie C, Xie Y . Antibiotic resistance and CYP2C19 polymorphisms affect the efficacy of concomitant therapies for Helicobacter pylori infection: an open-label, randomized, single-centre clinical trial. J Antimicrob Chemother. 2016; 71(8):2280-5. DOI: 10.1093/jac/dkw118. View

Song Z, Fu W, Zhou L . Cefuroxime, levofloxacin, esomeprazole, and bismuth as first-line therapy for eradicating Helicobacter pylori in patients allergic to penicillin. BMC Gastroenterol. 2019; 19(1):132. PMC: 6659276. DOI: 10.1186/s12876-019-1056-3. View

Fischbach L, Evans E . Meta-analysis: the effect of antibiotic resistance status on the efficacy of triple and quadruple first-line therapies for Helicobacter pylori. Aliment Pharmacol Ther. 2007; 26(3):343-57. DOI: 10.1111/j.1365-2036.2007.03386.x. View

10.

Suo B, Tian X, Li C, Song Z . [Dual therapy with rabeprazole and amoxicillin four times daily for 14 days for the first-line eradication of infection]. Zhonghua Yi Xue Za Zhi. 2019; 99(48):3781-3785. DOI: 10.3760/cma.j.issn.0376-2491.2019.48.005. View

11.

Sugano K, Tack J, Kuipers E, Graham D, El-Omar E, Miura S . Kyoto global consensus report on Helicobacter pylori gastritis. Gut. 2015; 64(9):1353-67. PMC: 4552923. DOI: 10.1136/gutjnl-2015-309252. View

12.

Hu Y, Zhou Z, Nan Q, Jiang H, Zhang L, Li X . [Study on metronidazole resistance to Helicobacter pylori from three populations with different ethnics in Yunnan]. Zhonghua Liu Xing Bing Xue Za Zhi. 2005; 25(11):986-8. View

13.

Liao J, Zheng Q, Liang X, Zhang W, Sun Q, Liu W . Effect of fluoroquinolone resistance on 14-day levofloxacin triple and triple plus bismuth quadruple therapy. Helicobacter. 2013; 18(5):373-7. PMC: 3974565. DOI: 10.1111/hel.12052. View

14.

Pan J, Shi Z, Lin D, Yang N, Meng F, Lin L . Is tailored therapy based on antibiotic susceptibility effective ? a multicenter, open-label, randomized trial. Front Med. 2020; 14(1):43-50. DOI: 10.1007/s11684-019-0706-8. View

15.

Xie Y, Zhu Z, Wang J, Zhang L, Zhang Z, Lu H . Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective,.... Antimicrob Agents Chemother. 2018; 62(9). PMC: 6125573. DOI: 10.1128/AAC.00432-18. View

16.

Fan X, Xue Q, Xian H, Sun Y, Zhao X, Wang J . [Tailored therapy in treatment of infectionbasedon clarithromycinsensitivity]. Zhonghua Yi Xue Za Zhi. 2019; 99(36):2826-2830. DOI: 10.3760/cma.j.issn.0376-2491.2019.36.006. View

17.

Liberati A, Altman D, Tetzlaff J, Mulrow C, Gotzsche P, Ioannidis J . The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009; 6(7):e1000100. PMC: 2707010. DOI: 10.1371/journal.pmed.1000100. View

18.

Yu L, Luo L, Long X, Liang X, Ji Y, Graham D . High-dose PPI-amoxicillin dual therapy with or without bismuth for first-line Helicobacter pylori therapy: A randomized trial. Helicobacter. 2019; 24(4):e12596. DOI: 10.1111/hel.12596. View

19.

Luo L, Huang Y, Liang X, Ji Y, Yu L, Lu H . Susceptibility-guided therapy for Helicobacter pylori-infected penicillin-allergic patients: A prospective clinical trial of first-line and rescue therapies. Helicobacter. 2020; 25(4):e12699. DOI: 10.1111/hel.12699. View

20.

Kuo Y, Liou J, El-Omar E, Wu J, Leow A, Goh K . Primary antibiotic resistance in Helicobacter pylori in the Asia-Pacific region: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2017; 2(10):707-715. DOI: 10.1016/S2468-1253(17)30219-4. View