Treffer: Genomic determinants of antibiotic resistance for Helicobacter pylori treatment: a retrospective phenotypic and genotypic observational study.

Title:
Genomic determinants of antibiotic resistance for Helicobacter pylori treatment: a retrospective phenotypic and genotypic observational study.
Authors:
Martínez-Martínez FJ; Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia (IBV), CSIC, Valencia, Spain., Chiner-Oms Á; Genomics of (Re)Emerging Pathogens, Genomics and Health Area, FISABIO - Public Health, Valencia, Spain; Joint Research Unit of Infection and Public Health, FISABIO-University of Valencia, Institute for Integrative Systems Biology (I2SysBio), Valencia, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain., Furió V; Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia (IBV), CSIC, Valencia, Spain., Yamaoka Y; Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Oita, Japan; Research Center for Global and Local Infectious Diseases, Oita University, Oita, Japan; Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX, USA., Dekker JP; Bacterial Pathogenesis and Antimicrobial Resistance Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA., Mégraud F; INSERM, UMR1312 Bordeaux Institute of Oncology, University of Bordeaux, Bordeaux, France., Bénéjat L; Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX, USA., Ducournau A; Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX, USA., Giese A; INSERM, UMR1312 Bordeaux Institute of Oncology, University of Bordeaux, Bordeaux, France., Jehanne Q; National Reference Center for Campylobacters & Helicobacters, Bordeaux Hospital University Center, Bordeaux, France., Jauvain M; INSERM, UMR1312 Bordeaux Institute of Oncology, University of Bordeaux, Bordeaux, France; National Reference Center for Campylobacters & Helicobacters, Bordeaux Hospital University Center, Bordeaux, France., Camargo MC; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA., Comas I; Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia (IBV), CSIC, Valencia, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain. Electronic address: icomas@ibv.csic.es., Lehours P; INSERM, UMR1312 Bordeaux Institute of Oncology, University of Bordeaux, Bordeaux, France; National Reference Center for Campylobacters & Helicobacters, Bordeaux Hospital University Center, Bordeaux, France.
Corporate Authors:
Source:
The Lancet. Microbe [Lancet Microbe] 2026 Jan; Vol. 7 (1), pp. 101217. Date of Electronic Publication: 2025 Dec 23.
Publication Type:
Journal Article; Observational Study
Language:
English
Journal Info:
Publisher: Elsevier Ltd Country of Publication: England NLM ID: 101769019 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2666-5247 (Electronic) Linking ISSN: 26665247 NLM ISO Abbreviation: Lancet Microbe Subsets: MEDLINE
Imprint Name(s):
Original Publication: [Oxford] : Elsevier Ltd., [2020]-
Contributed Indexing:
Investigator: FJ Martínez-Martínez, Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia (IBV), CSIC.; V Furió, Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia (IBV), CSIC.; I Comas, Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia (IBV), CSIC; CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.; Á Chiner-Oms, Genomics of (Re)Emerging Pathogens, Genomics and Health Area, FISABIO - Public Health, Valencia, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.; Y Yamaoka, Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Oita, Japan; Research Center for Global and Local Infectious Diseases, Oita University, Oita, Japan; Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX, USA.; JP Dekker, Bacterial Pathogenesis and Antimicrobial Resistance Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA.; F Megraud, INSERM, UMR1312 Bordeaux Institute of Oncology, University of Bordeaux, Bordeaux, France.; M Jauvain, INSERM, UMR1312 Bordeaux Institute of Oncology, University of Bordeaux, Bordeaux, France; National Reference Center for Campylobacters & Helicobacters, Bordeaux Hospital University Center, Bordeaux, France.; C Varon, INSERM, UMR1312 Bordeaux Institute of Oncology, University of Bordeaux, Bordeaux, France.; P Lehours, INSERM, UMR1312 Bordeaux Institute of Oncology, University of Bordeaux, Bordeaux, France; National Reference Center for Campylobacters & Helicobacters, Bordeaux Hospital University Center, Bordeaux, France.; Q Jehanne, National Reference Center for Campylobacters & Helicobacters, Bordeaux Hospital University Center, Bordeaux, France.; L Bénéjat, National Reference Center for Campylobacters & Helicobacters, Bordeaux Hospital University Center, Bordeaux, France.; A Ducournau, National Reference Center for Campylobacters & Helicobacters, Bordeaux Hospital University Center, Bordeaux, France.; J Romero-Gallo, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.; U Krishna, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.; RM Peek, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.; MB Piazuelo, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.; KT Wilson, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA.; JT Loh, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.; TL Cover, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA.; FF Vale, Pathogen Genome Bioinformatics and Computational Biology, Research Institute for Medicines, Faculty of Pharmacy, Universidade de Lisboa, Lisboa, Portugal; Instituto de Biosistemas e Ciências Integrativas, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal.; N Raaf, Department of Natural and Life Sciences, Faculty of Sciences, University of Algiers 1 Benyoucef Benkhedda, Algiers, Algeria.; H Aftab, Department of Gastroenterology, Dhaka Medical College and Hospital, Dhaka, Bangladesh.; J Akada, Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan.; T Matsumoto, Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan.; F Haesebrouck, Department of Pathobiology, Pharmacology and Zoological Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.; TF Bartelli, A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil; Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.; DN Nunes, A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil; Rutgers Cancer Institute, Newark, NJ, USA; Division of Cancer Biology, Department of Radiation Oncology, Rutgers New Jersey Medical School, Newark, NJ, USA.; A Pelosof, A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil.; CZ Sztokfisz, A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil.; E Dias-Neto, A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil; Rutgers Cancer Institute, Newark, NJ, USA; Division of Cancer Biology, Department of Radiation Oncology, Rutgers New Jersey Medical School, Newark, NJ, USA.; PP Assumpção, Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Pará, Brazil.; P Karagyozov, Medical University of Sofia, Sofia, Bulgaria.; I Tishkov, Medical University of Sofia, Sofia, Bulgaria.; KJ Goodman, Faculty of Medicine and Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, Canada.; J Geary, Faculty of Medicine and Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, Canada.; TJ Cromarty, Faculty of Medicine and Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, Canada.; NL Price, Faculty of Medicine and Dentistry, Department of Medicine, University of Alberta, Edmonton, AB, Canada.; D Quilty, Queen's University, Kingston, ON, Canada.; AH Corvalan, Department of Hematology and Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.; R Gonzalez, Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.; A Riquelme, Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Centro para la Prevención y Control del Cáncer (CECAN), Chile.; A García-Cancino, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile.; C Parra-Sepúlveda, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile; Doctorado en Ciencias mención Biología Celular y Molecular Aplicada, Universidad de la Frontera, Chile.; F Castillo, Hospital Hanga Roa, Easter Island, Chile.; MM Bravo, Grupo de Investigación en Biología del Cáncer, Instituto Nacional de Cancerología, Bogotá DC, Colombia.; A Pazos, Departamento de Biología, Universidad de Nariño, Pasto, Nariño, Colombia.; LE Bravo, Escuela de Medicina, Universidad del Valle, Cali, Valle, Colombia.; JG Fox, Division of Comparative Medicine, Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.; V Ramírez-Mayorga, Instituto de Investigaciones en Salud, Universidad de Costa Rica, San Jose, Costa Rica.; S Molina-Castro, Instituto de Investigaciones en Salud, Universidad de Costa Rica, San Jose, Costa Rica.; S Durán-Bermúdez, Laboratorio de Patología General y Gastrointestinal (LABGIPAT), San Jose, Costa Rica.; C Campos-Núñez, Servicio de Gastroenterología y Endoscopía Digestiva, Hospital Clínica Bíblica, San Jose, Costa Rica.; M Chaves-Cervantes, Servicio de Gastroenterología y Endoscopía Digestiva, Hospital Clínica Bíblica, San Jose, Costa Rica.; E Tshibangu-Kabamba, Faculty of Medicine, Osaka Metropolitan University, Osaka, Japan; Faculty of Medicine, University of Mbuji-Mayi, Mbuji Mayi, Kasai-Oriental, Democratic Republic of the Congo.; GD Tumba, Faculty of Medicine, University of Mbuji-Mayi, Mbuji Mayi, Kasai-Oriental, Democratic Republic of the Congo.; A Tshimpi-Wola, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.; P de Jesus Ngoma-Kisoko, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.; FM Tshibangu, Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan; Faculty of Medicine, University of Mbuji-Mayi, Mbuji Mayi, Kasai-Oriental, Democratic Republic of the Congo.; AC Mukanya, Faculty of Medicine, University of Mbuji-Mayi, Mbuji Mayi, Kasai-Oriental, Democratic Republic of the Congo.; TK Nkomba, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.; M Cruz, Instituto de Microbiología y Parasitología, Universidad Autónoma de Santo Domingo, Santo Domingo, Dominican Republic.; JJ Abreu, Dominican-Japanese Digestive Disease Center, Dr Luis E. Aybar Health and Hygiene City, Santo Domingo, Dominican Republic.; O Secka, Medical Research Council Unit, The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia.; A Link, Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.; P Malfertheiner, Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.; MB Adinortey, Department of Biochemistry, School of Biological Sciences, University of Cape Coast, Cape Coast, Central Region, Ghana.; AS Bockarie, Department of Internal Medicine and Therapeutics, School of Medical Sciences, University of Cape Coast, Cape Coast, Central Region, Ghana.; CA Adinortey, Department of Molecular Biology and Biotechnology, School of Biological Sciences, University of Cape Coast, Cape Coast, Central Region, Ghana.; EG Ofori, Department of Biology Education, Faculty of Science Education, University of Education, Winneba, Ghana.; DN Sgouras, Laboratory of Medical Microbiology, Hellenic Pasteur Institute, Athens, Greece.; B Martinez-Gonzalez, Laboratory of Medical Microbiology, Hellenic Pasteur Institute, Athens, Greece.; S Michopoulos, Department of Gastroenterology, Athens Medical, P. Faliron Hospital, Athens, Greece.; S Georgopoulos, Department of Gastroenterology, Alexandra Hospital, Athens, Greece.; E Hernandez, Facultad de Ciencias Médicas, University of San Carlos of Guatemala, Guatemala City, Guatemala.; RL Dominguez, Departamento de Medicina Interna, Hospital de Occidente, Santa Rosa de Copán, Honduras.; DR Morgan, School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, USA.; H Harðardóttir, Landspítali - The National University Hospital of Iceland, Reykjavík, Iceland.; AI Gunnarsdóttir, Landspítali - The National University Hospital of Iceland, Reykjavík, Iceland.; H Guðjónsson, Landspítali - The National University Hospital of Iceland, Reykjavík, Iceland.; JG Jónasson, Landspítali - The National University Hospital of Iceland, Reykjavík, Iceland; University of Iceland, Reykjavík, Iceland.; ES Björnsson, Landspítali - The National University Hospital of Iceland, Reykjavík, Iceland; University of Iceland, Reykjavík, Iceland.; M Ballal, Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.; V Shetty, Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India; Department of Medicine, University of Cambridge, Cambridge, UK.; M Miftahussurur, Universitas Airlangga, Surabaya, East Java, Indonesia.; T Sugihartono, Universitas Airlangga, Surabaya, East Java, Indonesia.; RI Alfaray, Universitas Airlangga, Surabaya, East Java, Indonesia.; LA Waskito, Universitas Airlangga, Surabaya, East Java, Indonesia.; KA Fauzia, National Research and Innovation Agency, Jakarta, Indonesia.; AF Syam, University of Indonesia, Jakarta, Indonesia.; H Maulahela, University of Indonesia, Jakarta, Indonesia.; R Malekzadeh, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.; A Peretz, Clinical Microbiology Laboratory and Research Institute, Tzafon Medical Center, affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Poriya, Israel; Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.; M Azrad, Clinical Microbiology Laboratory and Research Institute, Tzafon Medical Center, affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Poriya, Israel; Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.; A On, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel; Pediatric Gastroenterology and Nutrition Unit, Tzafon Medical Center, Poriya, Israel.; V De Re, Unit of Immunopathology and Oncological Biomarkers, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.; S Zanussi, Unit of Immunopathology and Oncological Biomarkers, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.; R Cannizzaro, Unit of Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy; Department of Medical, Surgical and Health Sciences, University of Trieste, Italy.; V Canzonieri, Unit of Pathology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy; Department of Medical, Surgical and Health Sciences, University of Trieste, Italy.; T Shimura, Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.; K Tokunaga, School of Medicine, Kyorin University, Mitaka, Tokyo, Japan.; T Osaki, School of Medicine, Kyorin University, Mitaka, Tokyo, Japan.; S Kamiya, School of Medicine, Kyorin University, Mitaka, Tokyo, Japan.; K Jadallah, Faculty of Medicine, Jordan University of Science and Technology, Ar Ramtha-Irbid, Jordan.; I Matalka, Faculty of Medicine, Jordan University of Science and Technology, Ar Ramtha-Irbid, Jordan.; NS Igissin, Research Institute of Life and Health Sciences, Higher School of Medicine, Kokshetau University named after Sh. Ualikhanov, Kokshetau, Kazakhstan; Central Asian Institute for Medical Research, Astana, Kazakhstan; Asian Pacific Organization for Cancer Prevention, Bishkek, Kyrgyzstan.; MS Moldobaeva, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.; A Rakhat, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.; IJ Choi, Center for Gastric Cancer, National Cancer Center, Goyang, South Korea.; JG Kim, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea.; N Kim, College of Medicine, Seoul National University, Seoul, South Korea.; M Leja, Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia; Digestive Diseases Centre GASTRO, Riga, Latvia; Riga East University Hospital, Riga, Latvia.; R Vangravs, Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.; Ģ Šķenders, Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia.; A Rūdule, Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.; I Kikuste, Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.; A Vanags, Digestive Diseases Centre GASTRO, Riga, Latvia.; D Rudzīte, Riga East University Hospital, Riga, Latvia.; J Kupcinskas, Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.; E Kiudeliene, Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.; V Kiudelis, Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.; R Gedgaudas, Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.; P Jonaitis, Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.; G Kiudelis, Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.; L Jonaitis, Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.; J Skieceviciene, Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.; J Vadivelu, Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia; Medical Education, Research and Development Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.; MF Loke, Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.; KM Vellasamy, Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.; R Herrera-Goepfert, Departamento de Patología, Instituto Nacional de Cancerología, Mexico City, Mexico.; JO Alonso-Larraga, Servicio de Endoscopía, Instituto Nacional de Cancerología, Mexico City, Mexico.; TT Yee, Department of Gastrointestinal and Hepatobiliary Surgery; Defence Services General Hospital (2/1000), Nay Pyi Taw, Myanmar.; K Htet, Department of Surgery, Defence Services General Hospital (1/1000), Yangon, Yangon Region, Myanmar.; T Matsuhisa, Department of Gastroenterology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.; PK Shrestha, Department of Gastroenterology, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.; S Ansari, Division of Health Sciences, Abu Dhabi Women's Campus, Higher Colleges of Technology, Abu Dhabi, United Arab Emirates.; O Abiodun, Department of Community Medicine, Babcock University, Ilishan, Ogun State, Nigeria.; C Jemilohun, Department of Medicine, Babcock University, Ilishan, Ogun State, Nigeria.; KO Akande, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria.; O Olu-Abiodun, Department of Nursing, Crescent University, Abeokuta, Ogun State, Nigeria.; FA Magaji, University Teaching Hospital, University of Jos, Jos, Plateau, Nigeria.; A Omotoso, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria.; U Okonkwo, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria.; CC Osuagwu, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria.; OO Owoseni, Department of Internal Medicine, Federal Medical Center Abeokuta, Abeokuta, Ogun State, Nigeria.; C Castaneda, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru.; M Castillo, Departamento de investigación, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.; B Velapatino, Universidad Peruana Cayetano Heredia, Lima, Peru.; RH Gilman, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.; P Krzyżek, Department of Microbiology, Wroclaw Medical University, Wrocław, Poland.; G Gościniak, Department of Microbiology, Wroclaw Medical University, Wrocław, Poland.; D Pawełka, Department of Surgery Teaching, Wroclaw Medical University, Wrocław, Poland.; I Korona-Glowniak, Department of Pharmaceutical Microbiology, Medical University of Lublin, Lublin, Poland.; H Cichoz-Lach, Department of Gastroenterology with Endoscopic Unit, Medical University of Lublin, Lublin, Poland.; M Oleastro, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal.; C Figueiredo, Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal.; JC Machado, Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal.; RM Ferreira, Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.; DS Bordin, Department of Pancreatic, Biliary and Upper Digestive Tract Disorders, A. S. Loginov Moscow Clinical Scientific Center, Moscow, Russia; Department of General Medical Practice and Family Medicine, Tver State Medical University, Moscow, Russia; Department of Propaedeutic of Internal diseases and Gastroenterology Russian University of Medicine, Moscow, Russia.; MA Livzan, Department of Faculty Therapy and Gastroenterology, Omsk State Medical University, Omsk, Russia.; VV Tsukanov, Scientific Research Institute of Medical Problems of the North, Federal Research Centre 'Krasnoyarsk Science Centre' of the Siberian Branch of Russian Academy of Science, Krasnoyarsk, Russia.; P Tan, Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore; Cancer and Stem Cell Biology Program, Duke NUS Medical School, Singapore, Singapore; Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore.; KG Yeoh, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Gastroenterology and Hepatology, National University Health System, Singapore, Singapore.; F Zhu, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; R Ally, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa; University of the Witwatersrand, Johannesburg, South Africa.; R Haas, Max von Pettenkofer Institute of Hygiene and Medical Microbiology, Faculty of Medicine, LMU Munich, Munich, Germany.; W Fischer, Max von Pettenkofer Institute of Hygiene and Medical Microbiology, Faculty of Medicine, LMU Munich, Munich, Germany.; M Montes, Donostia University Hospital-BioGipuzkoa Health Research Institute, San Sebastian-Donostia, Gipuzkoa, Spain.; M Fernández-Reyes, Hospital Universitario Donostia, San Sebastian, Spain.; E Tamayo, Hospital Universitario Donostia, San Sebastian, Spain.; J Lizasoain, Hospital Universitario Donostia, San Sebastian, Spain.; L Bujanda, Department of Gastroenterology, Bioodonostia Health Research Institute - Donostia University Hospital, Universidad del País Vasco (UPV/EHU), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), San Sebastian, Spain.; S Lario, Digestive Diseases Unit, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain.; MJ Ramírez-Lázaro, Digestive Diseases Unit, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain.; X Calvet, Digestive Diseases Unit, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain.; E Brunet-Mas, Digestive Diseases Unit, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain.; MJ Domper-Arnal, Barbastro General Hospital, Huesca, Spain; Aragon Health Research Institute, Zaragoza, Spain.; S García-Mateo, Lozano Blesa University Clinic Hospital, Zaragoza, Spain; Aragon Health Research Institute, Zaragoza, Spain.; D Abad-Baroja, Miguel Servet University Hospital, Zaragoza, Spain.; P Delgado-Guillena, Hospital General de Granollers, Barcelona, Spain.; L Moreira, Gastroenterology Department, Hospital Clínic of Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.; J Botargues, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.; I Pérez-Martínez, Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain.; E Barreiro-Alonso, Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Farmacology Group, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain; Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Asturias, Spain.; V Flores, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; JP Gisbert, Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa, Madrid, Spain; Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain.; EA Muro, Gastroenterology Department, Hospital Universitario de Navarra, Pamplona, Navarra, Spain.; P Linares, Hospital de Leon, Leon, Spain.; L Alcoba, Hospital de Leon, Leon, Spain.; V Martin, Institut of Biomedicine, University of León, Consortium for Biomedical Research in Epidemiology and Public Health, Leon, Spain.; L Engstrand, Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden.; H Enroth, University of Skövde, Skövde, Sweden.; PM Keller, Institute for Infectious Diseases, University of Bern, Bern, Switzerland; Clinical Bacteriology/Mycology Unit, University Hospital Basel, Basel, Switzerland.; K Wagner, Institute of Medical Microbiology, University of Zurich, Zürich, Switzerland.; D Pohl, Clinic for Gastroenterology and Hepatology, University Hospital Zurich, Zürich, Switzerland.; YC Lee, College of Medicine, National Taiwan University, Taipei City, Taiwan.; JM Liou, College of Medicine, National Taiwan University, Taipei City, Taiwan.; MS Wu, College of Medicine, National Taiwan University, Taipei City, Taiwan.; B Kocazeybek, Medical Microbiology Department, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, İstanbul, Türkiye.; S Sarıbas, Medical Microbiology Department, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, İstanbul, Türkiye.; İ Tasçı, General Surgery Department, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, İstanbul, Türkiye.; S Demiryas, General Surgery Department, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, İstanbul, Türkiye.; N Kepil, Medical Pathology Department, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, İstanbul, Türkiye.; L Quiel, Lawrence General Hospital, Lawrence, MA, USA.; M Villagra, Carson Tahoe Regional Medical Center, Carson City, NV, USA.; M Norton, White River Medical Center, Batesville, AR, USA.; D Johnson, White River Medical Center, Batesville, AR, USA.; RJ Huang, Department of Medicine, Stanford University, Stanford, CA, USA.; JH Hwang, Department of Medicine, Stanford University, Stanford, CA, USA.; W Szymczak, Albert Einstein College of Medicine, Bronx, NY, USA.; WR Jacobs, Albert Einstein College of Medicine, Bronx, NY, USA.; H In, Albert Einstein College of Medicine, Bronx, NY, USA; Rutgers Cancer Institute, New Brunswick, NJ, USA.; R Bollag, Georgia Cancer Center's Biorepository, Augusta University, Augusta, Georgia.; 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Substance Nomenclature:
0 (Anti-Bacterial Agents)
H1250JIK0A (Clarithromycin)
6GNT3Y5LMF (Levofloxacin)
0 (RNA, Ribosomal, 23S)
EC 5.99.1.3 (DNA Gyrase)
Entry Date(s):
Date Created: 20251226 Date Completed: 20260122 Latest Revision: 20260123
Update Code:
20260124
DOI:
10.1016/j.lanmic.2025.101217
PMID:
41453373
Database:
MEDLINE

Weitere Informationen

Background: Rising antimicrobial resistance of Helicobacter pylori is a public health challenge. Genomic-based susceptibility testing allows for the identification of resistance-associated mutations, complementing conventional diagnostics and advancing towards pathogen-based personalised therapies. Our study aimed to identify genes and mutations involved in antimicrobial resistance in H pylori and evaluate the extent to which these markers can be used as predictors of phenotypic resistance against clarithromycin and levofloxacin.
Methods: In this retrospective phenotypic and genotypic observational study, we included 1011 H pylori whole-genome sequences and strains of known geographical origin from the H pylori Genome Project (HpGP) collection. We performed phenotypic clarithromycin and levofloxacin susceptibility testing on a subset of 419 HpGP strains using Etest at a centralised laboratory. A genomic analysis was conducted to identify 23S rRNA and gyrA variants and build a curated catalogue of mutations associated with resistance to clarithromycin (ie, 23S rRNA 2142A→G, 2142A→C, and 2143A→G) and levofloxacin (ie, gyrA A88V or A88P, N87K or N87I, and D91G, D91N, or D91Y). Genotype-phenotype concordance was assessed to estimate sensitivity and specificity, and the curated catalogue of resistance-associated mutations was applied to the complete HpGP set. Region-specific prevalence of resistance-associated mutations was calculated for a combined dataset including the HpGP genomes and 768 whole-genome sequences retrieved from the US National Center for Biotechnology Information Sequence Read Archive repository. Associations between resistance genotypes, H pylori subpopulations, and minimum inhibitory concentrations (MICs) were tested.
Findings: Clarithromycin-resistant and levofloxacin-resistant HpGP strains were estimated with a sensitivity and specificity of 100%, with all confidence intervals ranging from 96% to 100%. The combined analysis (n=1779) found the highest prevalence of clarithromycin resistance in the western Pacific region (173 [51·2%] of 338 in southeast Asia and 75 [29·8%] of 252 in eastern Asia), north African region (seven [38·9%] of 18), and western Asian region (12 [31·6%] of 38), whereas the highest prevalence of levofloxacin resistance was found in south Asia (14 [51·85%] of 27), Central America (48 [38·7%] of 124), eastern Europe (four [36·4%] of 11), and southern Africa (three [33·3%] of nine). Similarly, 23S rRNA and gyrA genotypes are variable across H pylori subpopulations. MIC values changed depending on the specific mutation in 23S rRNA (mean clarithromycin MIC 24·61 mg/L [95% CI 12·27-36·96] for 2143A→G and 142·25 mg/L [95% CI 77·88-206·61] for 2142A→G) and gyrA (mean levofloxacin MIC 9·66 mg/L [95% CI 6·75-12·56] for mutations on codon 91, and 27·97 mg/L [95% CI 25·82-30·11] for mutations on codon 87).
Interpretation: Mutations in specific genes are reliable indicators to clarithromycin and levofloxacin resistance in H pylori, making them useful markers for the development of diagnostic assays and molecular monitoring. Our results suggest that using clarithromycin and levofloxacin empirically, without previous susceptibility testing, is unsuitable in all geographical regions covered by this study.
Funding: Intramural Research Program of the US National Cancer Institute, the European Research Council, and the Spanish Ministry of Science and Innovation.
(Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Declaration of interests We declare no competing interests.