1. Antibiotic resistance of Helicobacter pylori in Mainland China: A focus on geographic differences through systematic review and meta-analysis.
- Author
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Zeng S, Kong Q, Wu X, Duan M, Nan X, Yang X, Zuo X, Li Y, and Li Y
- Subjects
- China epidemiology, Humans, Clarithromycin pharmacology, Clarithromycin therapeutic use, Microbial Sensitivity Tests, Amoxicillin pharmacology, Amoxicillin therapeutic use, Tetracycline pharmacology, Tetracycline therapeutic use, Levofloxacin pharmacology, Levofloxacin therapeutic use, Metronidazole pharmacology, Metronidazole therapeutic use, Furazolidone pharmacology, Furazolidone therapeutic use, Helicobacter pylori drug effects, Helicobacter Infections drug therapy, Helicobacter Infections microbiology, Helicobacter Infections epidemiology, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Drug Resistance, Bacterial
- Abstract
Background: Empirical treatment needs to be supported by regional data, but knowledge of interregional differences is currently lacking in China. This study aimed to summarize and map the primary and secondary antibiotic resistance of Helicobacter pylori in different regions of mainland China., Methods: PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure and Wanfang databases were systematically reviewed for studies published between 1 January 2000 and 15 July 2023. Data related to primary and secondary H. pylori antibiotic resistance rates were included. Random-effects models were used to synthesize the pooled resistance rates., Results: Ultimately, 74 studies were included in the final analysis. A total of 16 provinces reported resistance data. The overall resistance rates of H. pylori in mainland China were 30.72% (95% CI 27.53%-33.99%) to clarithromycin, 70.14% (95% CI 29.53%-37.46%) to metronidazole and 32.98% (95% CI 28.73%-37.37%) to levofloxacin; for amoxicillin, tetracycline, and furazolidone, the rates were 2.41% (95% CI 1.43%-3.60%), 2.53% (95% CI 1.19%-4.28%) and 1.54% (95% CI 0.28%-3.62%), respectively. Spatial and temporal differences were observed. The resistance rates increased after treatment failure; however, secondary resistance to amoxicillin, tetracycline and furazolidone were still low across the vast majority of study regions., Conclusion: Surveillance of the updated prevalence of antibiotic resistance of H. pylori for different regions is warranted, which should factor into clinical decision making and guideline recommendations., Competing Interests: Declarations Funding: This study was supported by the National Natural Science Foundation of China (82270580 and 82070552), Key Research and Development Program of Shandong Province (2021CXGC010506). Competing interests: The all authors in this study report no conflicts of interest. Ethical approval: This study was exempt from ethical review since it not involve patients. The study had been registered on PROSPERO with the ID: CRD42023447179. Sequence information: Not applicable. Author contributions: Qingzhou Kong conceived of the study. Shuyan Zeng and Qingzhou Kong performed the systematic review and were responsible for editing the manuscript. Yueyue Li supervised the entire study and performed a critical revision of this article. Shuyan Zeng, Qingzhou Kong and Xiaoqi Wu were responsible for data collection, selecting, interpretation. Miao Duan and Xueping Nan assisted with data processing and analysis. Xiaoyun Yang, Xiuli Zuo and Yanqing Li critically reviewed and revised the article. All authors commented on or edited drafts and approved the final version of the manuscript., (Copyright © 2024 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.)
- Published
- 2024
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