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Updated: Jan 2, 2026
Detection of Helicobacter pylori Infection and Antibiotic Resistance via Stool Quantitative Polymerase Chain Reaction Analysis
Published on: May 16, 2025
Primary resistance of Helicobacter pylori is still low in Southern Austria
Ines Zollner-Schwetz1, Eva Leitner2, Wolfgang Plieschnegger3
1Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Austria.
Objectives:
We determined primary and secondary resistance rates of H. pylori in different regions of Austria and potential bacterial and host factors associated with resistance.
Methods:
In a prospective multicentre study H. pylori was cultivated from biopsies and susceptibility testing was performed according to EUCAST. Resistance to clarithromycin and levofloxacin was determined by sequencing of the resistance-determining regions of 23S rRNA and gyrA genes. cagA, vacA and babA2 genotypes were determined.
Results:
A total of 1266 patients were included. 178 isolates were cultured: 128 from patients without prior eradication therapy, 50 from patients after failed eradication. Primary resistance to clarithromycin, levofloxacin and metronidazole were 17.2%, 9.4% and 10.2%, respectively. Secondary resistance to clarithromycin, levofloxacin and metronidazole were 64%, 18% and 44%, respectively. Prior eradication was associated with a higher risk of clarithromycin as well as metronidazole resistance (OR=8.1; 95% CI 3.8-17.1 and OR 5.7; 95% CI 2.5-13, respectively).
Conclusion:
Primary resistance to both clarithromycin and levofloxacin was markedly lower in Southern Austria than recently reported.
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