2022年 · 第102卷第22期

Helicobacter pylori (Helicobacter pylori, H. pylori) is a gastric cancer class I carcinogen, eradicatedH. pyloriCan significantly reduce the incidence and mortality of gastric cancer. Antibiotic resistance is the cause ofH. pyloriEradicate the most important factor of treatment failure, so personalized diagnosis and treatment under the guidance of drug susceptibility is increasingly important. In order to strengthen theH. pyloriunderstanding of drug resistance mechanisms and searching for novel drug resistance genotype loci, the study resuscitated 60 strains from the Chinese Center for Molecular Medicine of Helicobacter Pylori (CCHpMM) strain libraryH. pylori, drug resistance phenotype detection and whole genome sequencing (WGS) were performed, and the consistency of drug resistance phenotype and genotype was evaluated. The results showed that the genotype and phenotype of resistance to clarithromycin and levofloxacin were almost identical, with Kappa coefficients of 0.867 and 0.833, respectively. All carrying R16H/C mutation and rdxA truncationH. pyloriAll had metronidazole resistance with a specificity of 100%. In addition, the study also found that two new sites, the A1378G mutation of HP0399 gene and the A149G mutation of FabH gene, may lead to tetracycline resistance and multidrug resistance, respectively. The results of this study suggest that the detection of drug resistance with clarithromycin and levofloxacin resistance genotypes is reliable, and WGS is very important to discover newH. pyloriresistance sites are of great help and contribute to the discovery ofH. pyloriNew resistance mechanisms provide the basis.

Helicobacter pylori (Helicobacter pylori，H. pylori) Drug resistance is an increasingly serious problem in China, seriously affectingH. pyloriTreatment of infections. To overcome this problem, individualized treatment needs to be guided based on local or individual antibiotic resistance phenotype and genotype data. The team of Professor Gao Hengjun at the China Center for Molecular Medicine of Helicobacter Pylori (CCHpMM) led this large-scale multicenter study to investigate ChinaH. pyloriThe drug resistance phenotype and genotype of. Studies were conducted from 5 regions (9 CCHpMM sub-centers) in ChinaH. pyloriIsolation and culture in gastric biopsy samples from infected subjectsH. pyloriThe strains were tested for antibiotic resistance phenotype and genotype, and the consistency of the two was evaluated. This study successfully isolated and cultured 4 242 strainsH. pyloriWith a success rate of 84.43%. Resistance phenotype results showedH. pyloriThe primary and secondary resistance rates to clarithromycin, levofloxacin, amoxicillin, furazolidone, tetracycline, metronidazole were 37.00% and 76.93%, 34.21% and 61.58%, 2.20% and 6.12%, 1.61% and 3.11%, 1.18% and 3.31%, 87.87% and 93.48%, respectively. The dual resistance rates of metronidazole/clarithromycin, metronidazole/levofloxacin, and clarithromycin/levofloxacin were 43.6%, 38.4%, and 26.1%, respectively.H. pyloriClarithromycin and levofloxacin resistance genotypes were mainly mutations at bases 2143 and 2143 of 23S rRNA and amino acids 87 and 91 of gyrA gene, and the Kappa coefficients of agreement with resistance phenotypes were 0.810 and 0.782, respectively.

About half of the world's population is infected with Helicobacter pylori, which is a risk factor for digestive diseases such as peptic ulcers and gastric cancer. Helicobacter pylori has also been reported to be associated with malignant tumors other than gastric cancer, such as colorectal tumors. To assess the relationship between H. pylori infection and colorectal tumors, the researchers conducted a systematic review and meta-analysis of the relevant literature. A meta-analysis was conducted by searching the Medline, Embase, and Cochrane Library databases for risk studies published up to September 2019 on colorectal adenoma, advanced colorectal adenoma, colorectal cancer, and H. pylori infection. Finally 48 studies were included in the meta-analysis, including 171 045 patients, of which 24, 8, and 31 reported H. pylori infection and risk of colorectal adenoma, advanced colorectal adenoma, and colorectal cancer, respectively. The results showed that H. pylori infection was significantly associated with the risk of colorectal adenomas (OR=1.49，95%CI：1.37~1.62）； Significantly associated with the risk of advanced colorectal adenomas (OR=1.50，95%CI：1.28~1.75）； Also significantly associated with the risk of colorectal cancer (OR=1.39，95%CI：1.27~1.52）。 Although this meta-analysis, based on observational studies, cannot show causality, it suggests that colorectal adenomas, advanced colorectal adenomas, and colorectal cancer are all associated with H. pylori infection.