Sequential changes of antibiotic resistances of in Taiwan from 2019 to 2024.
Journal
World journal of gastroenterology
Journal Volume
31
Journal Issue
39
Start Page
Article number 111380
ISSN
2219-2840
Date Issued
2025-10-21
Author(s)
Wu, Pei-Jui
Tsay, Feng-Woei
Wu, Deng-Chyang
Chuah, Seng-Kee
Chen, Kuan-Yang
Chen, Chien-Lin
Lee, Chia-Long
Shih, Chih-An
Liu, Yu-Hwa
Shiu, Sz-Iuan
Tai, Wei-Chen
Kuo, Chao-Hung
Lei, Wei-Yi
Kao, Sung-Shuo
Tsai, Tzung-Jiun
Feng, I-Che
Koseki, Mitsuhiro
Hsu, Ping-I
Sheu, Ming-Jen
Abstract
BACKGROUND Antibiotic resistance significantly impacts the treatment failure rates of Helicobacter pylori (H. pylori) infections. AIM To investigate the trends in primary antibiotic resistance of H. pylori in Taiwan over the past six years. METHODS We conducted a retrospective analysis of H. pylori isolates from Taiwanese who had not undergone previous treatments (n = 1408), collected between January 1, 2019 and December 31, 2024. Susceptibility of these strains to amoxicillin, clarithromycin, levofloxacin, metronidazole, and tetracycline was tested using the Epsilometer test. We analyzed the trends in single and dual resistance profiles over the study period, and compared antibiotic resistance across different regions (northern, southern and eastern areas) of Taiwan. RESULTS The overall resistance rates for H. pylori to amoxicillin, clarithromycin, metronidazole, tetracycline, and levofloxacin in Taiwan were 1.3%, 18.0%, 31.0%, 0.8%, and 28.7%, respectively. Tetracycline resistance increased significantly from 0% in 2019 to 3.5% in 2024 (P value in χ2 test for linear trend: < 0.001), while metronidazole resistance declined from 35.5% to 13.0% (P value in χ2 test for linear trend: < 0.001). No significant changes of amoxicillin, clarithromycin and levofloxacin resistances were observed. The dual resistances to clarithromycin plus tetracycline, and metronidazole plus tetracycline both increased significantly from 0% to 1.7% from 2019 to 2024 (P value in χ2 test for linear trend: < 0.05). Furthermore, no significant regional differences in resistance frequencies except for levofloxacin were detected. CONCLUSION Primary antibiotic resistance to tetracycline in H. pylori has increased in Taiwan from 2019 to 2024, while resistance to metronidazole has decreased during the same period. The dual resistance to clarithromycin plus tetracycline and metronidazole plus tetracycline both increased significantly.
Subjects
Amoxicillin
Antibiotic
Clarithromycin
Helicobacter pylori
Levofloxacin
Metronidazole
Resistance
Tetracycline
Type
journal article