Clarithromycin Resistance Patterns of Helicobacter pylori across Different Gastric Diseases in Uzbekistan

Abrorjon Yusupbekov; Takahiro Shinozuka; Jadida Ismailova; Otabek Tuychiev; Mitsuro Kanda; Junichi Sakamoto; Yanfang Zheng

doi:10.15403/jgld-6653

Authors

Abrorjon Yusupbekov Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology (National Cancer Center of Uzbekistan), Tashkent, Uzbekistan; Department of Oncology, Oncohematology and Medical Radiology, Tashkent State Medical University, Tashkent, Uzbekistan
Takahiro Shinozuka Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan https://orcid.org/0000-0002-2656-8361
Jadida Ismailova Republican Specialized Scientific and Practical Center for Therapy and Medical Rehabilitation, Tashkent, Uzbekistan; Department of Internal Medicine, Tashkent State Medical University, Tashkent, Uzbekistan
Otabek Tuychiev Department of Oncology, Oncohematology and Medical Radiology, Tashkent State Medical University, Tashkent, Uzbekistan; Department of Thoracic Surgical Oncology, Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology (National Cancer Center of Uzbekistan), Tashkent, Uzbekistan
Mitsuro Kanda Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
Junichi Sakamoto Tokai Central Hospital, Kakamigahara, Japan
Yanfang Zheng Guangzhou Institute of Cancer Research, the Affiliated Cancer Hospital, Guangzhou Medical University, Guangzhou, China

DOI:

https://doi.org/10.15403/jgld-6653

Keywords:

Helicobacter pylori, clarithromycin resistance, 23S rRNA mutation, gastric diseases, Uzbekistan

Abstract

Background and Aims: Helicobacter pylori (H. pylori) eradication is crucial for gastric cancer (GC) prevention. However, increasing clarithromycin (CLR) resistance (CLRR) poses significant challenges. This study aimed to investigate CLRR patterns across different gastric diseases in Uzbekistan.

Methods: We retrospectively analyzed 279 H. pylori-infected patients with chronic non-atrophic gastritis (CNAG), chronic atrophic gastritis (CAG), gastric ulcer (GU), mucosa-associated lymphoid tissue lymphoma (MALT-L), or GC between 2020-2022. Among 194 cagA-positive patients who received eradication therapy, CLRR was defined by 23S rRNA mutations (A2142G, A2142C, A2143G) or treatment failure with CLR-based regimens. Logistic regression identified factors associated with CLRR, evaluated by univariate and multivariate analysis, and predicted probability models were generated based on disease type and patient characteristics.

Results: The overall CLRR rate was 44.8% (87/194), with 41.2% showing genotypic resistance. CLRR rates increased with disease severity: CNAG (33.3%), CAG (31.7%), GU (59.3%), MALT-L (54.1%), and GC (69.6%). Multivariate analysis identified older age (OR=2.27, 95%CI: 1.05-5.10), GU (OR=2.65, 95%CI: 1.04-6.96), and GC (OR=3.73, 95%CI: 1.34-11.2) as independent CLRR predictors. Disease-specific patterns emerged: GU and GC showed positive associations between age / body mass index and CLRR probability, while MALT-L demonstrated inverse relationships.

Conclusions: High CLRR rates in Uzbekistan correlate with gastric disease severity. The disease-specific CLRR probability patterns identified in our study provide a practical framework for optimizing empirical therapy selection when comprehensive resistance testing is unavailable.