Epidemiological characteristics of Helicobacter pylori infection and antibiotic resistance in urban areas of Guangdong Province, China: a multi-center, cross-sectional surveillance.

Purpose: Helicobacter pylori (H. pylori) infection is widespread globally and can cause serious gastrointestinal complications, including gastric cancer. This study assesses the prevalence and antibiotic resistance of H. pylori in Guangdong, one of China's most developed provinces.

Methods: A multi-center, cross-sectional study was conducted across six cities in Guangdong provinces, that is, Guangzhou, Shenzhen, Heyuan, Foshan, Yunfu, and Zhaoqing. Non-invasive gastric fluid samples were collected via the string test, and H. pylori infection and antibiotic resistance were detected using quantitative PCR. Risk factors for infection were analyzed.

Results: Of 1,764 participants, 444 (25.17%) tested positive for H. pylori, with the highest infection rate in Foshan (29.81%). Antibiotic resistance testing of these 444 infected individuals revealed that, except for levofloxacin resistance in Yunfu (14.29%), clarithromycin resistance in Yunfu and resistance to other antibiotics in all cities exceeded the 15% threshold. Infection rates were significantly higher in males (OR 1.29, 95% CI 1.03-1.60, p = 0.03) and obese individuals (OR 2.04, 95% CI 1.04-3.91, p = 0.03), with obesity identified as an independent risk factor.

Conclusion: This study provides a comprehensive update on the prevalence, antibiotic resistance, and risk factors of H. pylori infection in Guangdong, offering valuable insights for public health strategies aimed at improving diagnosis and treatment.