Related Experiment Video
Updated: Jul 13, 2025
Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Antimicrobial-resistant Helicobacter pylori in Japan: Report of nationwide surveillance for 2018-2020
Tadayoshi Okimoto1,2,3, Takashi Ando1,4, Makoto Sasaki1,5
1Committee on Surveillance of Antimicrobial-resistant Helicobacter pylori Strains, The Japanese Society for Helicobacter Research, Tokyo, Japan.
Background:
Antimicrobial therapy is necessary to eradicate Helicobacter pylori infection. The emergence of antimicrobial-resistant bacteria poses a threat to continued treatment with antimicrobial agents. For those who prescribe antimicrobial therapy, it is necessary to constantly monitor the emergence of antimicrobial-resistant bacteria.
Method:
H. pylori clinical isolates were collected in Japan from August 2018 to December 2020 for antimicrobial susceptibility testing. The agar dilution method was used for the determination of the minimum inhibitory concentration (MIC) of clarithromycin (CLR), amoxicillin (AMX), metronidazole (MNZ), and sitafloxacin (STX).
Results:
MICs for 938 H. pylori isolates were examined. The primary resistance rates of H. pylori clinical isolates for CLR, AMX, MNZ, and STX in Japan were 35.5%, 2.7%, 4.2%, and 27.6%, respectively. The primary resistance rates for CLR, AMX, and MNZ were significantly higher than those of the 2002-2005 isolates. The resistance rate for CLR was significantly higher in females (males: 30.7%, females: 41.5%, p < 0.001) and higher in the ≤29 years age group (54.8%) than in the other age groups, although there were no significant differences (p = 0.104). The MNZ resistance rate was significantly higher in the ≤29 years age group than in the other age groups (p = 0.004). The resistance rate for STX increased with age, but a significant difference was only seen between the 30-49 years age group and the ≥70 years age group (p < 0.001), and the resistance rate was significantly higher in strains isolated in the Kyushu region than in the other regions (p < 0.001).
Conclusions:
The primary resistance rates for CLR, AMX, and MNZ of H. pylori clinical isolates in Japan were higher than those of the 2002-2005 isolates. Continuous surveillance is needed to monitor the trends in antimicrobial-resistant H. pylori.
Insights
Antimicrobial resistance in Helicobacter pylori is increasing in Japan, with clarithromycin resistance notably high. Continuous monitoring of antimicrobial resistance trends is crucial for effective H. pylori treatment.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Helicobacter pylori eradication relies on antimicrobial therapy.
- The rise of antimicrobial resistance threatens treatment efficacy.
- Monitoring antimicrobial resistance in H. pylori is essential for public health.
Purpose of the Study:
- To assess current antimicrobial susceptibility patterns of H. pylori clinical isolates in Japan.
- To compare resistance rates with historical data.
- To identify trends in antimicrobial resistance.
Main Methods:
- Collected H. pylori clinical isolates in Japan between August 2018 and December 2020.
- Determined minimum inhibitory concentrations (MICs) using the agar dilution method.
- Tested susceptibility to clarithromycin, amoxicillin, metronidazole, and sitafloxacin.
Main Results:
- High primary resistance rates observed: 35.5% for clarithromycin, 2.7% for amoxicillin, 4.2% for metronidazole, and 27.6% for sitafloxacin.
- Resistance rates for clarithromycin, amoxicillin, and metronidazole were significantly higher than in 2002-2005.
- Clarithromycin resistance was higher in females and younger individuals; metronidazole resistance was higher in the ≤29 years age group; sitafloxacin resistance increased with age and was higher in the Kyushu region.
Conclusions:
- Primary resistance rates for key H. pylori antibiotics have increased in Japan compared to previous years.
- Ongoing surveillance of antimicrobial resistance in H. pylori is necessary.
- These findings highlight the need for updated treatment guidelines and strategies.
Related Concept Videos
01:16Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:28Acid Suppressive Drugs for Peptic Ulcer Disease: Histamine H2-Receptor Antagonists
01:30Development of Antibiotic Resistance
01:13Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
01:28Antimicrobial Effectiveness