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 of Chi...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 of China over the past six years.METHODS We conducted a retrospective analysis of H.pylori isolates from Taiwan residents,China 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 of China.RESULTS The overall resistance rates for H.pylori to amoxicillin,clarithromycin,metronidazole,tetracycline,and levofloxacin in Taiwan of China 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 inχ^(2)test for linear trend:<0.001),while metronidazole resistance declined from 35.5%to 13.0%(P value inχ^(2)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 inχ^(2)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 of China 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.展开更多
AIM To determine whether capsaicin infusion could influence heartburn perception and secondary peristalsis in patients with gastroesophageal reflux disease(GERD). METHODS Secondary peristalsis was performed with slow ...AIM To determine whether capsaicin infusion could influence heartburn perception and secondary peristalsis in patients with gastroesophageal reflux disease(GERD). METHODS Secondary peristalsis was performed with slow and rapid mid-esophageal injections of air in 10 patients with GERD. In a first protocol, saline and capsaicincontaining red pepper sauce infusions were randomly performed, whereas 2 consecutive sessions of capsaicin-containing red pepper sauce infusions were performed in a second protocol. Tested solutions including 5 m L of red pepper sauce diluted with 15 m L of saline and 20 m L of 0.9% saline were infused into the mid-esophagus via the manometric catheter at a rate of 10 mL /min with a randomized and doubleblind fashion. During each study protocol, perception of heartburn, threshold volumes and peristaltic parameters for secondary peristalsis were analyzed and compared between different stimuli.RESULTS Infusion of capsaicin significantly increased heartburn perception in patients with GERD(P < 0.001), whereas repeated capsaicin infusion significantly reduced heartburn perception(P = 0.003). Acute capsaicin infusion decreased threshold volume of secondary peristalsis(P = 0.001) and increased its frequency(P = 0.01) during rapid air injection. The prevalence of GERD patients with successive secondary peristalsis during slow air injection significantly increased after capsaicin infusion(P = 0.001). Repeated capsaicin infusion increased threshold volume of secondary peristalsis(P = 0.002) and reduced the frequency of secondary peristalsis(P = 0.02) during rapid air injection. CONCLUSION Acute esophageal exposure to capsaicin enhances heartburn sensation and promotes secondary peristalsis in gastroesophageal reflux disease, but repetitive capsaicin infusion reverses these effects.展开更多
基金Supported by the An Nan Hospital,China Medical University,No.ANHRF114-20 and No.ANHRF114-21.
文摘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 of China over the past six years.METHODS We conducted a retrospective analysis of H.pylori isolates from Taiwan residents,China 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 of China.RESULTS The overall resistance rates for H.pylori to amoxicillin,clarithromycin,metronidazole,tetracycline,and levofloxacin in Taiwan of China 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 inχ^(2)test for linear trend:<0.001),while metronidazole resistance declined from 35.5%to 13.0%(P value inχ^(2)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 inχ^(2)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 of China 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.
文摘AIM To determine whether capsaicin infusion could influence heartburn perception and secondary peristalsis in patients with gastroesophageal reflux disease(GERD). METHODS Secondary peristalsis was performed with slow and rapid mid-esophageal injections of air in 10 patients with GERD. In a first protocol, saline and capsaicincontaining red pepper sauce infusions were randomly performed, whereas 2 consecutive sessions of capsaicin-containing red pepper sauce infusions were performed in a second protocol. Tested solutions including 5 m L of red pepper sauce diluted with 15 m L of saline and 20 m L of 0.9% saline were infused into the mid-esophagus via the manometric catheter at a rate of 10 mL /min with a randomized and doubleblind fashion. During each study protocol, perception of heartburn, threshold volumes and peristaltic parameters for secondary peristalsis were analyzed and compared between different stimuli.RESULTS Infusion of capsaicin significantly increased heartburn perception in patients with GERD(P < 0.001), whereas repeated capsaicin infusion significantly reduced heartburn perception(P = 0.003). Acute capsaicin infusion decreased threshold volume of secondary peristalsis(P = 0.001) and increased its frequency(P = 0.01) during rapid air injection. The prevalence of GERD patients with successive secondary peristalsis during slow air injection significantly increased after capsaicin infusion(P = 0.001). Repeated capsaicin infusion increased threshold volume of secondary peristalsis(P = 0.002) and reduced the frequency of secondary peristalsis(P = 0.02) during rapid air injection. CONCLUSION Acute esophageal exposure to capsaicin enhances heartburn sensation and promotes secondary peristalsis in gastroesophageal reflux disease, but repetitive capsaicin infusion reverses these effects.
