Analysis Of Helicobacter Pylori Infection Status,Antibiotic Resistance And Treatment Strategies In The Guilin Region

Objectives:The aim of this study is to analyze the situation of Helicobacter pylori infection in the Guilin region,as well as to detect the drug resistance of Helicobacter pylori to commonly used antibiotics and analyze the related clinical influencing factors.The findings of this study can provide guidance for the clinical treatment of Helicobacter pylori eradication.Methods:A total of 57,220 patients who underwent ¹³C-urea breath test examination in the Affiliated Hospital of Guilin Medical College from January2017 to December 2022 were selected for statistical analysis of Helicobacter pylori infection status.A total of 234 Helicobacter pylori infected patients who underwent Helicobacter pylori culture and drug sensitivity test from November2022 to February 2023 were also selected as study subjects.Gastric mucosal biopsy specimens were collected for Helicobacter pylori isolation and culture,antibiotic susceptibility testing is performed using the paper disc diffusion method.We detected the resistance rate and resistance pattern of Helicobacter pylori to commonly used antibiotics,analyzed the impact of various clinical factors on antibiotic resistance,and statistical the customary prescriptions of outpatient physicians for Helicobacter pylori eradication.Results:1.The Helicobacter pylori infection rate was 38.4%in 57,220patients.The Helicobacter pylori infection rate for each year from 2017 to 2022is 40.5%,39.6%,37.8%,35.5%,33.3%and 45.0%respectively.The Helicobacter pylori infection rate was 39.1%in male patients and 37.8%in female patients,χ²=9.877,P<0.05,with a statistically significant difference.The highest Helicobacter pylori infection rate was observed in the 40-49 age group,at 42%.2.The Helicobacter pylori culture-positive rate is 91.03%.According to the antibiotic susceptibility test results,the resistance rate of amoxicillin,clarithromycin,metronidazole,furazolidone,tetracycline,rifampin,levofloxacin,and gentamicin is 7.51%,22.54%,92.96%,6.57%,0.47%,9.39%,45.54%and16.43%respectively.The dual resistance rate is 26.76%,and the multiple resistance rate reaches 35.21%.The results of the univariate analysis found that gender,place of residence,history of Helicobacter pylori eradication therapy,endoscopic diagnosis,and antibiotic use history in the last 6 months among patients show statistically significant differences in antibiotic resistance rates（P<0.05）,while age,dietary habits,¹³C-urea breath test results,and family history of gastric cancer among patients do not show statistically significant differences in antibiotic resistance rates（P>0.05）.The results of the multifactorial analysis found that history of Helicobacter pylori eradication therapy（OR=4.692,95%CI=1.659-13.274）and antibiotic use history in the last 6months（OR=2.699,95%CI=1.358-5.367）were independent risk factors for clarithromycin resistance（P<0.05）.Gender（OR=0.447,95%CI=0.254-0.785）and antibiotic use history in the last 6 months（OR=2.383,95%CI=1.324-4.287）were independent risk factors for levofloxacin resistance（P<0.05）.Conclusions:1.The Helicobacter pylori infection rate in the Guilin region was within the national level,and the Helicobacter pylori infection rate increased significantly in 2022.There was a difference between genders,and the Helicobacter pylori infection rate was the highest in the age group of 40-49years.2.Helicobacter pylori in the Guilin region shows high resistance rates to metronidazole and levofloxacin,this means that these antibiotics are not suitable as first-line treatment options.Amoxicillin,furazolidone,and tetracycline have relatively lower resistance rates,and these three antibiotics can be used as preferred first-line treatment options for Helicobacter pylori eradication.3.For Helicobacter pylori eradication in the Guilin region,a combination of sensitive antibiotics（such as amoxicillin and tetracycline,amoxicillin and furazolidone,tetracycline and furazolidone）or high-dose proton pump inhibitors and amoxicillin dual therapy is recommended.