Antibiotic Resistance of and Related Risk Factors in Yangzhou, China: A Cross-Sectional Study.

Background: The antibiotic resistance of () is a common cause of treatment failure. Previous studies showed that resistance may be related to some characteristics of patients. This study intended to investigate the resistance of to five commonly used antibiotics and risk factors in Yangzhou, China.

Methods: We recruited the subjects who joined the endoscopic screening program organized by the Affiliated Hospital of Yangzhou University between April 2018 and September 2019 and endoscopists would take biopsy samples from the antrum and the corpus of the stomach. The antrum biopsy specimens were used to culture . Next, we extracted DNA from strains and performed the specific DNA amplification. Finally, we use gene chip technology to test the susceptibility to clarithromycin, levofloxacin, metronidazole, amoxicillin and tetracycline. Multivariate logistic analyses were also performed to determine the risk factors for antibiotic resistance of .

Results: A total of 461 strains were finally collected. The resistance rate of to clarithromycin, levofloxacin, metronidazole, amoxicillin and tetracycline was 41.0%, 44.9%, 38.8%, 6.3% and 1.1%, respectively. In addition, 16 multi-resistance patterns were detected, and strains resistant to all five antibiotics were not found. Multivariate analysis showed that past medical history and clinical outcomes were significantly associated with the resistance to clarithromycin. Drinking, gastrointestinal symptoms and a family history of gastric cancer were significantly associated with the resistance of to levofloxacin. Especially gastrointestinal symptoms were significantly associated with the resistance of to any antibiotic.

Conclusion: The resistance rates of to clarithromycin, levofloxacin and metronidazole were very high in Yangzhou, China, various factors were related to bacterial resistance, and grasping these influencing factors can guide treatment.