Multidrug-Resistant Helicobacter pylori Strains Identified in Vietnamese Patients with Gastric Disease

Strategic Insights -

Researchers at the 108 Military Central Hospital in Vietnam have identified novel sequence types of multidrug-resistant Helicobacter pylori strains in patients with gastric diseases. The genome of these strains was characterized, revealing high similarity with the Asian genotype and possession of virulence genes, including toxin-encoding genes cagA and vacA. The study also detected antibiotic-resistant mutations and provided insights into the pathobiology and spread of these strains.

Key Takeaways:

  • Researchers identified novel sequence types ST4511, ST4512, and ST4513 of multidrug-resistant Helicobacter pylori strains in Vietnamese patients with gastric diseases.
  • The genome of these strains was de novo assembled, followed by in silico analysis of multilocus sequence typing (MLST), core-genome based phylogeny, and genetic determinants associated with virulence, biofilm formation, and antibiotic-resistance.
  • The strains possessed 128 to 131 virulence genes, including toxin-encoding genes cagA and vacA.
  • Double amoxicillin-resistant mutations on pbp1 and pbp2, or a mutation on pbp3, triple clarithromycin-resistant mutations on 23S rRNA gene, and a levofloxacin-resistant mutation on gyrA were detected in antibiotic-resistant strains.
  • Mutations on rdxA were detected in both metronidazole-resistant and -sensitive strains, whereas frxA mutations were detected in only one metronidazole-sensitive strain.
  • This study provides insights into the genome of multidrug-resistant H. pylori strains of a novel sequence type circulating in Vietnam for future investigations of its pathobiology and spread through human populations.

Statistics:

  • 3 multidrug-resistant Helicobacter pylori strains of novel sequence types were identified in 108 Military Central Hospital patients.
  • The strains' genome sequence exhibited high similarity with the Asian genotype (ANI values of 98.5% to 99.2%).
  • The strains possessed 128 to 131 virulence genes.
  • 100% of the antibiotic-resistant strains showed mutations on pbp1 and pbp2, or a mutation on pbp3, triple clarithromycin-resistant mutations on 23S rRNA gene, and a levofloxacin-resistant mutation on gyrA.
  • 50% of the metronidazole-resistant strains showed mutations on rdxA, whereas 100% of the metronidazole-sensitive strains showed no mutations on rdxA.

Sources:

  • "Genomic insights into virulence, biofilm formation, and antimicrobial resistance of multidrug-resistant Helicobacter pylori strains of novel sequence types isolated from Vietnamese patients with gastric diseases." Journal of Global Antimicrobial Resistance, 2025, 43():237-241.
  • "Researchers at 108 Military Central Hospital Target Gastric Disease (Genomic insights into virulence, biofilm formation, and antimicrobial resistance of multidrug-resistant Helicobacter pylori strains of novel sequence types isolated from ...)." Health & Medicine Week. June 20, 2025; p 4133.