Objective: To explore the rate of Helicobacter pylori (Hp) resistance to levofloxacin and clarithromycin and the common mutation patterns of resistance genes in Ningxia, and to assess the concordance between phenotypic resistance and genotypic resistance. Methods: Cross-sectional study. Patients diagnosed with Hp infection in 14 hospitals in Ningxia region from February 2020 to May 2022 were retrospectively selected. Hp strains were isolated from gastric biopsy specimens of Hp-infected patients and subjected to phenotypic drug sensitivity testing and detection of resistance genes to analyze the rate of Hp resistance to levofloxacin and clarithromycin and the common mutation patterns of resistance genes in Ningxia region; and the concordance rate and Kappa concordance test were used to assess the concordance between phenotypic resistance and genotypic resistance. Results: A total of 1 942 Hp strains were isolated and cultured, and among the infections, 1 069 cases (55.0%) were male and 873 cases (45.0%) were female, aged (50.0±12.5) years (15-86 years). The rates of Hp resistance to levofloxacin and clarithromycin in Ningxia were 42.1% (818/1 942) and 40.1% (779/1 942), respectively, and the rate of dual resistance to both was 22.8% (443/1 942). The rate of resistance to levofloxacin and clarithromycin of Hp strains from female patients was higher than in male patients (levofloxacin: 50.4%(440/873) vs 35.4%(378/1 069); clarithromycin: 44.4%(388/873) vs 36.6%(391/1 069), both P<0.001). Among the GyrA gene mutations associated with levofloxacin resistance, the differences in mutation rate of amino acid at positions 87 and 91 were statistically significant in both drug-resistant and sensitive strains(both P<0.001), except for Asn87Thr. Hp strains were statistically significant for levofloxacin (Kappa=0.834, P<0.001) and clarithromycin (Kappa=0.829, P<0.001) had good concordance in resistance at the phenotypic and genotypic levels. Conclusion: The resistance of Hp to levofloxacin and clarithromycin in Ningxia region is severe, and there is good consistency between genotypic and phenotypic resistance.
目的： 探索宁夏地区幽门螺杆菌（Hp）对左氧氟沙星和克拉霉素耐药率及耐药基因的常见突变方式，评估其表型与基因型耐药的一致性。 方法： 横断面研究。回顾性选取2020年2月至2022年5月宁夏地区14家医院确诊为Hp感染的患者。从Hp感染患者的胃活检标本中分离到Hp菌株，进行表型药敏试验和耐药基因的检测，分析宁夏地区Hp对左氧氟沙星和克拉霉素耐药率及耐药基因常见突变方式；采用符合率和Kappa系数评估表型与基因型耐药的一致性。 结果： 共分离培养1 942株Hp，感染者中，男1 069例（55.0%），女873例（45.0%），年龄（50.0±12.5）岁（15~86岁）。宁夏地区Hp对左氧氟沙星和克拉霉素耐药率分别为42.1%（818/1 942）和40.1%（779/1 942），双重耐药率为22.8%（443/1 942）。其中来自女性患者的Hp菌株对左氧氟沙星和克拉霉素耐药率均较男性高（左氧氟沙星：50.4%（440/873）比35.4%（378/1 069）；克拉霉素：44.4%（388/873）比36.6%（391/1 069），均P<0.001）。与左氧氟沙星耐药有关的GyrA基因突变中，除了Asn87Thr外，第87和91位氨基酸突变率在耐药菌株和敏感菌株间的差异均有统计学意义（均P<0.001）。Hp菌株对左氧氟沙星（Kappa=0.834，P<0.001）和克拉霉素（Kappa=0.829，P<0.001）的耐药性在表型和基因型上具有良好的一致性。 结论： 宁夏地区Hp对左氧氟沙星和克拉霉素的耐药严重，基因型和表型耐药具有良好的一致性。.