Helicobacter pylori antibiotic resistance genes and virulence based on fecal samples in Qinghai, China: A...

Antibiotic resistance in Helicobacter pylori (H pylori) is influenced by multiple factors and shows significant geographical variation. Qinghai has a high incidence of gastric cancer and a high prevalence of H pylori infection, which may be exacerbated by factors such as limited healthcare resources, an underdeveloped surveillance system, a challenging geographical environment and climate, and distinct local lifestyle habits. This study aimed to investigate the distribution of resistance genes and virulence factors of H pylori strains isolated from patients in the Qinghai region to levofloxacin, clarithromycin, amoxicillin, tetracycline, and furazolidone, in order to provide a scientific basis for the precise treatment of H pylori in Qinghai. Between October 2024 and August 2025, 151 patients in Qinghai province who underwent 13C-urea breath testing for H pylori infection were enrolled. The overall antibiotic resistance rate of H pylori in Qinghai province was 80.60%, with the highest rate observed for clarithromycin (58.21%) and the lowest for tetracycline (14.18%). Resistance rates for levofloxacin, amoxicillin, and furazolidone were 41.04%, 17.91%, and 17.91%, respectively. The rates of dual and multidrug resistance were 31.34% and 17.91%, respectively. Antibiotic resistance in H pylori from Qinghai poses a significant challenge, with a concomitantly high detection rate of virulence factors. Therefore, it is imperative to proactively implement antibiotic susceptibility testing and assess relevant influence factors for H pylori-infected patients in Qinghai prior to the 1st eradication therapy to reduce antibiotic resistance.