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Antimicrobial Resistance of Helicobacter Pylori Among Low-resource Chinese Minorities

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机构: [1]Kunming Med Univ, Affiliated Hosp 1, Phys Examinat Ctr, Kunming, Yunnan, Peoples R China [2]Chinese Ctr Dis Control & Prevent, Natl Inst Communicable Dis Control & Prevent, State Key Lab Infect Dis Prevent & Control, Collaborat Innovat Ctr Diag & Treatment Infect Di, Beijing, Peoples R China [3]Yunnan Univ, Affiliated Hosp, Phys Examinat Ctr, Peoples Hosp Yunnan Prov 2,Yunnan Prov Eye Hosp, Kunming, Yunnan, Peoples R China [4]Yunnan Univ, Affiliated Hosp, Digest Internal Med, Phys Examinat Ctr,Peoples Hosp Yunnan Prov 2,Yunn, Kunming, Yunnan, Peoples R China
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Context . Helicobacter pylori (H. pylori) infection has become a global public-health problem, and people living in low-resource settings may be more likely to be infected because of unhealthy life habits, poor sanitary conditions, and overuse of antibiotics without a prescription. Objectives . The study intended to assess the susceptibility of H. pylori to nine antibiotics commonly prescribed for eradication of H. pylori infections among minority people in Yunnan province, China, to provide updated recommendations for H. pylori eradication therapy among adults. Design . The research team designed a cross-sectional observational study. Setting . The study took place in the First Affiliated Hospital of Kunming Medical University, Yunnan Province. Participants . Participants were 276 people in the Mosuo or Pumi minority population who had lived on the shores of Lugu Lake in Ninglang county, Yunnan province in China for generations. Outcome Measures . After completing a questionnaire, all participants underwent 13C-urea breath test, and those with a positive result participated in an antimicrobial-susceptibility test. For each H. pylori isolate, the research team tested the minimum inhibitory concentrations (MICs) of nine commonly used antibiotics: amoxicillin, azithromycin, levofloxacin, clarithromycin, metronidazole, tetracycline, rifampicin, gentamicin, and moxifloxacin. Results . The research team confirmed that 276 participants were resistant to at least one antibiotic. The resistances rates for moxifloxacin, metronidazole, and levofloxacin were the highest, while that for amoxicillin was the lowest, and no isolates were resistant to gentamicin. Double resistance (33.20%) had the highest proportion of all multiple-resistance patterns. Moreover, the metronidazole resistance rate was higher in females than in males and in nonsmokers than in smokers, and rifampicin resistance was higher in nondrinkers than in drinkers, suggesting that smoking and drinking might be protective against metronidazole and rifampicin resistance. Conclusions . Most of the Mosuo and Pumi people in Yunnan were resistant to antibiotics. Moxifloxacin, metronidazole, and levofloxacin should no longer be the main medicines for H. pylori, whereas amoxicillin and gentamicin should be recommended to be the first-line clinical therapy for H. pylori eradication regimens.

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大类 | 4 区 医学
小类 | 4 区 全科医学与补充医学
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Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE
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Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

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第一作者机构: [1]Kunming Med Univ, Affiliated Hosp 1, Phys Examinat Ctr, Kunming, Yunnan, Peoples R China
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