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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Clinical Microbiology
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1505166

Helicobacter pylori Resistance in Hainan Province, China: Investigating Phenotypes and Genotypes through Whole-Genome Sequencing

Provisionally accepted
Yanting Lv Yanting Lv 1,2Da Li Da Li 1,2Daya Zhang Daya Zhang 1,2Shiju Chen Shiju Chen 1,2Runxiang Chen Runxiang Chen 1,2Jiajia Chen Jiajia Chen 3Lei Gao Lei Gao 4Zengjun Tao Zengjun Tao 4Jianxin Xiong Jianxin Xiong 5QiuYa Huang QiuYa Huang 5Jing Huang Jing Huang 6Qiaoguan Zhang Qiaoguan Zhang 6Weizhong Yang Weizhong Yang 2Feihu Bai Feihu Bai 2*
  • 1 Hainan Medical University, Haikou, China
  • 2 Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
  • 3 Qionghai People's Hospital, Qionghai, China
  • 4 The Third People's Hospital of Hainan Province, Sanya, China
  • 5 Hainan Second People's Hospital, Wuzhishan, Hainan Province, China
  • 6 Dongfang People's Hospital, Dongfang, China

The final, formatted version of the article will be published soon.

    Helicobacter pylori is increasingly resistant to antibiotics, significantly lowering eradication rates and posing a major public health challenge. This study investigated the distribution of antibiotic-resistant phenotypes and genotypes of H. pylori in Hainan Province. It determined the minimum inhibitory concentrations (MICs) of six antibiotics using the E-test method and detected resistance genes via Sanger sequencing. Furthermore, we compared resistance detection based on phenotypic analysis and whole genome sequencing (WGS) across 19 clinical isolates of H. pylori.A total of 140 H. pylori strains were isolated. The resistance rates to levofloxacin (LEV), clarithromycin (CLA), and metronidazole (MTZ) were 37.9%, 40.0%, and 93.6%, respectively. Notably, only 3.3% of the strains were susceptible to all six antibiotics. Multidrug-resistant strains accounted for 25.0% of the total, with no resistance detected to amoxicillin (AMX), tetracycline (TET), or furazolidone (FR) during the study period. Genotypic resistance to CLA and LEV showed near-perfect concordance with phenotypic resistance, with Kappa values of 0.910 and 0.938, respectively. Although all isolates were phenotypically sensitive to TET, 16 exhibited a mutation in the 16S rRNA gene (A926G). All strains harboring the R16H/C mutation and truncated rdxA were resistant to metronidazole, demonstrating a specificity of 100%. Therefore, FR, AMX, and TET are recommended as suitable empirical treatment options for H. pylori infections in this region. Genotypic analysis provides a reliable method for predicting resistance to CLA and LEV. WGS proves to be a valuable tool for identifying novel resistance loci in H. pylori and contributes to the phylogenetic classification of strains.

    Keywords: Helicobacter pylori, antibiotic resistance, genotypic, phenotypic, lineage, Whole-genome sequencing

    Received: 03 Oct 2024; Accepted: 22 Nov 2024.

    Copyright: © 2024 Lv, Li, Zhang, Chen, Chen, Chen, Gao, Tao, Xiong, Huang, Huang, Zhang, Yang and Bai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Feihu Bai, Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China

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