Antimicrobial Resistance Profile of Helicobacter pylori in Shenzhen, China: A Retrospective Study From 2021 to 2024
In brief
Over 85% of untreated H. pylori in Shenzhen resistant to metronidazole
In a review of 1,200 gastric isolates from 2021-2024, 87% of treatment-naïve H. pylori were resistant to metronidazole, while clarithromycin and levofloxacin resistance rose sharply after prior therapy (68% and 51%). Resistance to amoxicillin, furazolidone and tetracycline remained low, prompting authors to favor bismuth-based quadruple or high-dose dual regimens for first-line treatment and susceptibility-guided therapy after failure.
- Journal
- Helicobacter (Q1)
- Published
- 1 January 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Fan Wu, Ye Chen, Chenghai Yang
- PMID
- 42538641
- DOI
- 10.1111/hel.70154
Why clinicians should know about it
- Picked for Microbiology (medical) (paper of the day, 2 August 2026): Antimicrobial resistance profile of Helicobacter pylori isolates
Abstract
BACKGROUND: The escalating antibiotic resistance of Helicobacter pylori (H. pylori) poses a significant threat to global public health. Continuous local surveillance is crucial due to substantial geographical and temporal variations in resistance patterns. OBJECTIVE: This study aimed to characterize the antimicrobial resistance profile of H. pylori in Shenzhen, China, between 2021 and 2024, and to assess temporal trends and demographic associations. METHODS: We conducted a retrospective analysis of patients who underwent gastroscopy at Shenzhen Hospital of Southern Medical University from March 2021 to October 2024. Gastric mucosal biopsies were collected for H. pylori culture, and antimicrobial susceptibility testing was performed using the agar dilution method. RESULTS: Among culture-positive isolates, 225 were from treatment-naïve patients and 975 from previously treated patients. Resistance rates in the treatment-naïve vs. previously treated groups were: clarithromycin 17.8% vs. 68.0%, metronidazole 87.1% vs. 97.4%, levofloxacin 11.1% vs. 50.9%, amoxicillin 0.4% vs. 3.1%, and furazolidone 0% vs. 0.1%. No tetracycline-resistant isolates were identified. Significant temporal increases were observed in secondary resistance to clarithromycin, amoxicillin, and metronidazole, as well as in the prevalence of multidrug resistance (all p < 0.05). No sex-based differences were detected in either primary or secondary resistance rates (all p > 0.05). Secondary resistance to clarithromycin, metronidazole, and levofloxacin varied significantly across age groups (p < 0.05), whereas primary resistance rates did not. CONCLUSIONS: Between 2021 and 2024, H. pylori isolates in Shenzhen exhibited high resistance rates to metronidazole, clarithromycin, and levofloxacin, while susceptibility to amoxicillin, furazolidone, and tetracycline remained preserved. Secondary resistance rates increased progressively over time, accompanied by a growing burden of multidrug resistance. Bismuth-containing quadruple therapy and high-dose dual therapy are recommended as first-line empirical regimens for treatment-naïve patients, whereas susceptibility-guided therapy is warranted for those with prior treatment failure.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.