Comprehensive characterization of gastrointestinal microbiota dysbiosis in patients with refractory Helicobacter pylori infection

作者：Yu Li, Xinbo Xu, Chao Peng, Yichen Liu, Nonghua Lü, Yin Zhu, Cong He · 发表于：mSystems · 年份：2025 · DOI：10.1128/msystems.01090-25 · 被引用次数：4 · 研究领域：Helicobacter pylori-related gastroenterology studies、Clostridium difficile and Clostridium perfringens research、Microscopic Colitis

ABSTRACT While repeated Helicobacter pylori eradication attempts are increasingly common due to antimicrobial resistance, the compounding effects of multiple antibiotic courses on gastrointestinal microbiota remain unquantified. We enrolled 32 treatment-naïve patients and 84 patients with refractory H. pylori infections, defined as failure of at least two prior eradication attempts. Antibiotic susceptibility testing was conducted for refractory H. pylori isolates to assess resistance patterns. Gastric mucosal biopsies and fecal samples were obtained for 16S rRNA gene sequencing. Antimicrobial susceptibility testing revealed resistance rates of 96.55% to metronidazole, 77.59% to clarithromycin, 56.90% to levofloxacin, 5.17% to rifampicin, 1.72% to tetracycline, and 0% to amoxicillin and furazolidone. The rates of dual drug and multidrug resistance were 27.59% and 55.17%, respectively. Refractory patients exhibited significant gastric microbiota restructuring, marked by reduced alpha diversity. The refractory group had higher concentrations of pathogens like Pseudomonas and Burkholderia and lower relative abundances of beneficial bacteria, including Bifidobacterium , Blautia , and Roseburia . Levofloxacin-resistant individuals exhibited an amplified abundance of pathogenic Veillonella . The gastric microbial diversity was higher in clarithromycin-resistant patients, with the enrichment of Micromonospora . Compared with the single-resistant group, pathogens, such as Veillonella ...