{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T07:59:15Z","timestamp":1787990355850,"version":"build-2784847793"},"reference-count":58,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Jinan Clinical Medical Science and Technology Innovation Program","award":["202328036"],"award-info":[{"award-number":["202328036"]}]},{"name":"Shandong Medical and Health Science and Technology Development Plan Project","award":["202202080452"],"award-info":[{"award-number":["202202080452"]}]},{"name":"Shandong Medical and Health Science and Technology Development Plan Project","award":["202202080452"],"award-info":[{"award-number":["202202080452"]}]},{"name":"Shandong Medical and Health Science and Technology Development Plan Project","award":["202202080452"],"award-info":[{"award-number":["202202080452"]}]},{"name":"Shandong Medical and Health Science and Technology Development Plan Project","award":["202202080452"],"award-info":[{"award-number":["202202080452"]}]},{"name":"Shandong Medical and Health Science and Technology Development Plan Project","award":["202202080452"],"award-info":[{"award-number":["202202080452"]}]},{"name":"Shandong Medical and Health Science and Technology Development Plan Project","award":["202202080452"],"award-info":[{"award-number":["202202080452"]}]},{"name":"Shandong Medical and Health Science and Technology Development Plan Project","award":["202202080452"],"award-info":[{"award-number":["202202080452"]}]},{"name":"Shandong Medical and Health Science and Technology Development Plan Project","award":["202202080452"],"award-info":[{"award-number":["202202080452"]}]},{"name":"Shandong Medical and Health Science and Technology Development Plan Project","award":["202202080452"],"award-info":[{"award-number":["202202080452"]}]},{"name":"Shandong Medical and Health Science and Technology Development Plan Project","award":["202202080452"],"award-info":[{"award-number":["202202080452"]}]},{"name":"Shandong Medical and Health Science and Technology Development Plan Project","award":["202202080452"],"award-info":[{"award-number":["202202080452"]}]},{"name":"Shandong Medical and Health Science and Technology Development Plan Project","award":["202202080452"],"award-info":[{"award-number":["202202080452"]}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"crossref","award":["ZR2021QC219"],"award-info":[{"award-number":["ZR2021QC219"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-16264-2","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T09:14:56Z","timestamp":1759310096000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Helicobacter pylori antimicrobial resistance and gene variants in Shandong Province"],"prefix":"10.1038","volume":"15","author":[{"given":"Zhijing","family":"Xue","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengyan","family":"Pei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanan","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youjun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanran","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingqing","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juanjuan","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohai","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"issue":"1","key":"16264_CR1","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1007\/s42770-021-00675-0","volume":"53","author":"HC Sharndama","year":"2022","unstructured":"Sharndama, H. C. & Mba, I. E. Helicobacter pylori: an up-to-date overview on the virulence and pathogenesis mechanisms. Braz J. Microbiol. 53 (1), 33\u201350 (2022).","journal-title":"Braz J. Microbiol."},{"issue":"1","key":"16264_CR2","doi-asserted-by":"publisher","first-page":"e12865","DOI":"10.1111\/hel.12865","volume":"27","author":"H Shi","year":"2022","unstructured":"Shi, H. et al. Helicobacter pylori infection and the progression of atherosclerosis: A systematic review and meta-analysis. Helicobacter 27 (1), e12865 (2022).","journal-title":"Helicobacter"},{"issue":"12","key":"16264_CR3","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1056\/NEJMoa1708423","volume":"378","author":"IJ Choi","year":"2018","unstructured":"Choi, I. J. et al. Helicobacter pylori therapy for the prevention of metachronous gastric cancer. N Engl. J. Med. 378 (12), 1085\u20131095 (2018).","journal-title":"N Engl. J. Med."},{"issue":"5","key":"16264_CR4","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1053\/j.gastro.2018.07.007","volume":"155","author":"A Savoldi","year":"2018","unstructured":"Savoldi, A., Carrara, E., Graham, D. Y., Conti, M. & Tacconelli, E. Prevalence of antibiotic resistance in Helicobacter pylori: A systematic review and Meta-analysis in world health organization regions. Gastroenterology 155 (5), 1372\u201382e17 (2018).","journal-title":"Gastroenterology"},{"key":"16264_CR5","doi-asserted-by":"publisher","first-page":"125148","DOI":"10.1016\/j.jhazmat.2021.125148","volume":"411","author":"S Li","year":"2021","unstructured":"Li, S. et al. Technologies towards antibiotic resistance genes (ARGs) removal from aquatic environment: A critical review. J. Hazard. Mater. 411, 125148 (2021).","journal-title":"J. Hazard. Mater."},{"issue":"9","key":"16264_CR6","doi-asserted-by":"publisher","first-page":"1724","DOI":"10.1136\/gutjnl-2022-327745","volume":"71","author":"P Malfertheiner","year":"2022","unstructured":"Malfertheiner, P. et al. Management of Helicobacter pylori infection: The Maastricht vi\/florence consensus report. Gut 71 (9), 1724\u20131762 (2022).","journal-title":"Gut"},{"issue":"12","key":"16264_CR7","doi-asserted-by":"publisher","first-page":"1736","DOI":"10.1038\/ajg.2016.443","volume":"111","author":"Q Chen","year":"2016","unstructured":"Chen, Q. et al. Rescue therapy for Helicobacter pylori eradication: A randomized Non-Inferiority trial of amoxicillin or Tetracycline in bismuth quadruple therapy. Am. J. Gastroenterol. 111 (12), 1736\u20131742 (2016).","journal-title":"Am. J. Gastroenterol."},{"issue":"1","key":"16264_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/hel.12178","volume":"20","author":"C Xie","year":"2015","unstructured":"Xie, C. & Lu, N. H. Review: clinical management of Helicobacter pylori infection in China. Helicobacter 20 (1), 1\u201310 (2015).","journal-title":"Helicobacter"},{"issue":"2","key":"16264_CR9","first-page":"403","volume":"10","author":"R Borka","year":"2023","unstructured":"Borka Balas, R., Melit, L. E. & Marginean, C. O. Current worldwide trends in pediatric Helicobacter pylori antimicrobial resistance. Child. (Basel) 10 (2), 403 (2023).","journal-title":"Child. (Basel)"},{"issue":"4","key":"16264_CR10","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1111\/apt.13497","volume":"43","author":"I Thung","year":"2016","unstructured":"Thung, I. et al. Review article: the global emergence of Helicobacter pylori antibiotic resistance. Aliment. Pharmacol. Ther. 43 (4), 514\u2013533 (2016).","journal-title":"Aliment. Pharmacol. Ther."},{"issue":"2","key":"16264_CR11","doi-asserted-by":"publisher","first-page":"e12475","DOI":"10.1111\/hel.12475","volume":"23","author":"WZ Liu","year":"2018","unstructured":"Liu, W. Z. et al. Fifth Chinese National consensus report on the management of Helicobacter pylori infection. Helicobacter 23 (2), e12475 (2018).","journal-title":"Helicobacter"},{"issue":"6","key":"16264_CR12","doi-asserted-by":"publisher","first-page":"e12531","DOI":"10.1111\/hel.12531","volume":"23","author":"F Siavoshi","year":"2018","unstructured":"Siavoshi, F., Saniee, P. & Malekzadeh, R. Effective antimicrobial activity of Rifabutin against multidrug-resistant Helicobacter pylori. Helicobacter 23 (6), e12531 (2018).","journal-title":"Helicobacter"},{"issue":"8","key":"16264_CR13","doi-asserted-by":"publisher","first-page":"2034","DOI":"10.1093\/jac\/dky167","volume":"73","author":"M Bachir","year":"2018","unstructured":"Bachir, M. et al. Molecular detection of mutations involved in Helicobacter pylori antibiotic resistance in Algeria. J. Antimicrob. Chemother. 73 (8), 2034\u20132038 (2018).","journal-title":"J. Antimicrob. Chemother."},{"key":"16264_CR14","doi-asserted-by":"publisher","first-page":"6436256","DOI":"10.1155\/2022\/6436256","volume":"2022","author":"L Tian","year":"2022","unstructured":"Tian, L. et al. Direct detection of antibiotic resistance in Chinese Helicobacter pylori clinical isolates by sequencing-based approach. J. Healthc. Eng. 2022, 6436256 (2022).","journal-title":"J. Healthc. Eng."},{"issue":"2","key":"16264_CR15","doi-asserted-by":"publisher","first-page":"311","DOI":"10.18388\/abp.2014_1901","volume":"61","author":"K Klesiewicz","year":"2014","unstructured":"Klesiewicz, K. et al. PCR-RFLP detection of point mutations A2143G and A2142G in 23S rRNA gene conferring resistance to clarithromycin in Helicobacter pylori strains. Acta Biochim. Pol. 61 (2), 311\u2013315 (2014).","journal-title":"Acta Biochim. Pol."},{"issue":"3","key":"16264_CR16","doi-asserted-by":"publisher","first-page":"164","DOI":"10.5662\/wjm.v5.i3.164","volume":"5","author":"R Ghotaslou","year":"2015","unstructured":"Ghotaslou, R., Leylabadlo, H. E. & Asl, Y. M. Prevalence of antibiotic resistance in Helicobacter pylori: A recent literature review. World J. Methodol. 5 (3), 164\u2013174 (2015).","journal-title":"World J. Methodol."},{"issue":"3","key":"16264_CR17","first-page":"212","volume":"45","author":"RS Zheng","year":"2023","unstructured":"Zheng, R. S. et al. [Cancer statistics in china, 2016]. Zhonghua Zhong Liu Za Zhi. 45 (3), 212\u2013220 (2023).","journal-title":"Zhonghua Zhong Liu Za Zhi"},{"issue":"9","key":"16264_CR18","doi-asserted-by":"publisher","first-page":"e0309844","DOI":"10.1371\/journal.pone.0309844","volume":"19","author":"Z Xue","year":"2024","unstructured":"Xue, Z. et al. Virulence gene polymorphisms in Shandong Helicobacter pylori strains and their relevance to gastric cancer. PLoS One. 19 (9), e0309844 (2024).","journal-title":"PLoS One"},{"issue":"5","key":"16264_CR19","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1093\/jac\/dkm039","volume":"59","author":"E Glocker","year":"2007","unstructured":"Glocker, E., Bogdan, C. & Kist, M. Characterization of rifampicin-resistant clinical Helicobacter pylori isolates from Germany. J. Antimicrob. Chemother. 59 (5), 874\u2013879 (2007).","journal-title":"J. Antimicrob. Chemother."},{"key":"16264_CR20","unstructured":"Clinical & Laboratory, S. I. Methods for Antimicrobial Dilution and Disk Susceptibility Testing of Infrequently Isolated or Fastidious Bacteria (M45 3rd edn (Clinical and Laboratory Standards Institute, 2016)."},{"issue":"10","key":"16264_CR21","doi-asserted-by":"publisher","first-page":"3138","DOI":"10.1128\/AAC.47.10.3138-3144.2003","volume":"47","author":"LM Best","year":"2003","unstructured":"Best, L. M. et al. Multilaboratory comparison of proficiencies in susceptibility testing of Helicobacter pylori and correlation between agar Dilution and E test methods. Antimicrob. Agents Chemother. 47 (10), 3138\u20133144 (2003).","journal-title":"Antimicrob. Agents Chemother."},{"issue":"4","key":"16264_CR22","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.1590\/S1517-83822014000400039","volume":"45","author":"SK Ogata","year":"2014","unstructured":"Ogata, S. K., Gales, A. C. & Kawakami, E. Antimicrobial susceptibility testing for Helicobacter pylori isolates from Brazilian children and adolescents: comparing agar dilution, E-test, and disk diffusion. Braz J. Microbiol. 45 (4), 1439\u20131448 (2014).","journal-title":"Braz J. Microbiol."},{"issue":"7","key":"16264_CR23","doi-asserted-by":"publisher","first-page":"1842","DOI":"10.1128\/jcm.35.7.1842-1846.1997","volume":"35","author":"R Piccolomini","year":"1997","unstructured":"Piccolomini, R., Di Bonaventura, G., Catamo, G., Carbone, F. & Neri, M. Comparative evaluation of the E test, agar dilution, and broth microdilution for testing susceptibilities of Helicobacter pylori strains to 20 antimicrobial agents. J. Clin. Microbiol. 35 (7), 1842\u20131846 (1997).","journal-title":"J. Clin. Microbiol."},{"issue":"4","key":"16264_CR24","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.1128\/JCM.36.4.1165-1166.1998","volume":"36","author":"T Alarcon","year":"1998","unstructured":"Alarcon, T., Domingo, D. & Lopez-Brea, M. Discrepancies between E-test and agar Dilution methods for testing metronidazole susceptibility of Helicobacter pylori. J. Clin. Microbiol. 36 (4), 1165\u20131166 (1998).","journal-title":"J. Clin. Microbiol."},{"issue":"1","key":"16264_CR25","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/S0934-8840(11)80799-1","volume":"282","author":"G von Recklinghausen","year":"1995","unstructured":"von Recklinghausen, G. & Ansorg, R. Metronidazole susceptibility testing of Helicobacter pylori with the PDM epsilometer test (E test). Zentralbl Bakteriol. 282 (1), 83\u201385 (1995).","journal-title":"Zentralbl Bakteriol"},{"key":"16264_CR26","doi-asserted-by":"publisher","first-page":"801537","DOI":"10.3389\/fmicb.2022.801537","volume":"13","author":"J Chen","year":"2022","unstructured":"Chen, J., Huang, Y., Ding, Z., Liang, X. & Lu, H. E-Test or agar Dilution for metronidazole susceptibility testing of Helicobacter pylori: importance of the prevalence of metronidazole resistance. Front. Microbiol. 13, 801537 (2022).","journal-title":"Front. Microbiol."},{"issue":"2","key":"16264_CR27","first-page":"224","volume":"29","author":"J Yang","year":"2023","unstructured":"Yang, J. et al. Antimicrobial resistance of Helicobacter pylori among low-resource Chinese minorities. Altern. Ther. Health Med. 29 (2), 224\u2013229 (2023).","journal-title":"Altern. Ther. Health Med."},{"issue":"1","key":"16264_CR28","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1093\/jac\/43.1.47","volume":"43","author":"MP Dore","year":"1999","unstructured":"Dore, M. P. et al. Amoxycillin tolerance in Helicobacter pylori. J. Antimicrob. Chemother. 43 (1), 47\u201354 (1999).","journal-title":"J. Antimicrob. Chemother."},{"issue":"7","key":"16264_CR29","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1016\/j.cmi.2017.11.010","volume":"24","author":"DS Liu","year":"2018","unstructured":"Liu, D. S. et al. Primary antibiotic resistance of Helicobacter pylori in Chinese patients: a multiregion prospective 7-year study. Clin. Microbiol. Infect. 24 (7), 780 (2018). e5- e8.","journal-title":"Clin. Microbiol. Infect."},{"issue":"10","key":"16264_CR30","doi-asserted-by":"publisher","first-page":"646","DOI":"10.3390\/antibiotics9100646","volume":"9","author":"JY Park","year":"2020","unstructured":"Park, J. Y. et al. The prevalence of multidrug resistance of Helicobacter pylori and its impact on eradication in Korea from 2017 to 2019: A single-center study. Antibiot. (Basel) 9 (10), 646 (2020).","journal-title":"Antibiot. (Basel)"},{"issue":"14","key":"16264_CR31","doi-asserted-by":"publisher","first-page":"1531","DOI":"10.3748\/wjg.v24.i14.1531","volume":"24","author":"AJ Matta","year":"2018","unstructured":"Matta, A. J., Zambrano, D. C. & Pazos, A. J. Punctual mutations in 23S rRNA gene of clarithromycin-resistant Helicobacter pylori in Colombian populations. World J. Gastroenterol. 24 (14), 1531\u20131539 (2018).","journal-title":"World J. Gastroenterol."},{"key":"16264_CR32","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1186\/s13756-019-0632-1","volume":"8","author":"DS Liu","year":"2019","unstructured":"Liu, D. S. et al. Characteristics of Helicobacter pylori antibiotic resistance: data from four different populations. Antimicrob. Resist. Infect. Control. 8, 192 (2019).","journal-title":"Antimicrob. Resist. Infect. Control"},{"issue":"1","key":"16264_CR33","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1186\/s12879-022-07160-5","volume":"22","author":"W Lei","year":"2022","unstructured":"Lei, W. et al. Pseudomembranous necrotizing laryngotracheobronchitis due to Mycoplasma pneumoniae: a case report and literature review. BMC Infect. Dis. 22 (1), 183 (2022).","journal-title":"BMC Infect. Dis."},{"issue":"1","key":"16264_CR34","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1128\/JCM.42.1.387-389.2004","volume":"42","author":"T Falsafi","year":"2004","unstructured":"Falsafi, T., Mobasheri, F., Nariman, F. & Najafi, M. Susceptibilities to different antibiotics of Helicobacter pylori strains isolated from patients at the pediatric medical center of tehran, Iran. J. Clin. Microbiol. 42 (1), 387\u2013389 (2004).","journal-title":"J. Clin. Microbiol."},{"issue":"5","key":"16264_CR35","doi-asserted-by":"publisher","first-page":"e0055023","DOI":"10.1128\/spectrum.00550-23","volume":"11","author":"M Xiong","year":"2023","unstructured":"Xiong, M. et al. Phenotype and genotype analysis for Helicobacter pylori antibiotic resistance in outpatients: a retrospective study. Microbiol. Spectr. 11 (5), e0055023 (2023).","journal-title":"Microbiol. Spectr."},{"issue":"3","key":"16264_CR36","doi-asserted-by":"publisher","first-page":"816","DOI":"10.3390\/jcm12030816","volume":"12","author":"Y Zhang","year":"2023","unstructured":"Zhang, Y. et al. Antibiotic resistance of Helicobacter pylori and related risk factors in yangzhou, china: A cross-sectional study. J. Clin. Med. 12 (3), 816 (2023).","journal-title":"J. Clin. Med."},{"issue":"8","key":"16264_CR37","doi-asserted-by":"publisher","first-page":"e29774","DOI":"10.1016\/j.heliyon.2024.e29774","volume":"10","author":"Y Chen","year":"2024","unstructured":"Chen, Y. et al. Role of MIC levels and 23S rRNA mutation sites to clarithromycin in 14-day clarithromycin bismuth quadruple therapy for Helicobacter pylori eradication: A prospective trial in Beijing. Heliyon 10 (8), e29774 (2024).","journal-title":"Heliyon"},{"issue":"1","key":"16264_CR38","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1186\/s12866-025-03990-w","volume":"25","author":"PH Bui","year":"2025","unstructured":"Bui, P. H. et al. Identification of genetic determinants of antibiotic resistance in Helicobacter pylori isolates in Vietnam by high-throughput sequencing. BMC Microbiol. 25 (1), 264 (2025).","journal-title":"BMC Microbiol."},{"key":"16264_CR39","doi-asserted-by":"publisher","first-page":"3051","DOI":"10.2147\/IDR.S219069","volume":"12","author":"A Hanafiah","year":"2019","unstructured":"Hanafiah, A., Binmaeil, H., Raja Ali, R. A., Mohamed Rose, I. & Lopes, B. S. Molecular characterization and prevalence of antibiotic resistance in Helicobacter pylori isolates in Kuala lumpur, Malaysia. Infect. Drug Resist. 12, 3051\u20133061 (2019).","journal-title":"Infect. Drug Resist."},{"issue":"7","key":"16264_CR40","doi-asserted-by":"publisher","first-page":"e101481","DOI":"10.1371\/journal.pone.0101481","volume":"9","author":"X Teh","year":"2014","unstructured":"Teh, X. et al. Functional and molecular surveillance of Helicobacter pylori antibiotic resistance in Kuala Lumpur. PLoS One. 9 (7), e101481 (2014).","journal-title":"PLoS One"},{"issue":"9","key":"16264_CR41","doi-asserted-by":"publisher","first-page":"e00019-18","DOI":"10.1128\/JCM.00019-18","volume":"56","author":"L Sun","year":"2018","unstructured":"Sun, L. et al. Droplet digital PCR-based detection of clarithromycin resistance in Helicobacter pylori isolates reveals frequent heteroresistance. J. Clin. Microbiol. 56 (9), e00019-18 (2018).","journal-title":"J. Clin. Microbiol."},{"issue":"1","key":"16264_CR42","doi-asserted-by":"publisher","first-page":"e12939","DOI":"10.1111\/hel.12939","volume":"28","author":"JW Lee","year":"2023","unstructured":"Lee, J. W. et al. Prevalence and trends of multiple antimicrobial resistance of Helicobacter pylori in one tertiary hospital for 20 years in Korea. Helicobacter 28 (1), e12939 (2023).","journal-title":"Helicobacter"},{"issue":"3","key":"16264_CR43","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1093\/jac\/dky469","volume":"74","author":"V De Francesco","year":"2019","unstructured":"De Francesco, V. et al. Role of MIC levels of resistance to clarithromycin and metronidazole in Helicobacter pylori eradication. J. Antimicrob. Chemother. 74 (3), 772\u2013774 (2019).","journal-title":"J. Antimicrob. Chemother."},{"key":"16264_CR44","doi-asserted-by":"publisher","first-page":"8547686","DOI":"10.1155\/2016\/8547686","volume":"2016","author":"R Han","year":"2016","unstructured":"Han, R. et al. Multicenter study of antibiotic resistance profile of H. pylori and distribution of CYP2C19 gene polymorphism in rural population of chongqing, China. Gastroenterol. Res. Pract. 2016, 8547686 (2016).","journal-title":"Gastroenterol. Res. Pract."},{"issue":"23","key":"16264_CR45","doi-asserted-by":"publisher","first-page":"4306","DOI":"10.1111\/febs.12020","volume":"279","author":"M Martinez-Julvez","year":"2012","unstructured":"Martinez-Julvez, M. et al. Structure of RdxA\u2013an oxygen-insensitive nitroreductase essential for metronidazole activation in Helicobacter pylori. FEBS J. 279 (23), 4306\u20134317 (2012).","journal-title":"FEBS J."},{"key":"16264_CR46","doi-asserted-by":"publisher","first-page":"106303","DOI":"10.1016\/j.micpath.2023.106303","volume":"183","author":"Z Huang","year":"2023","unstructured":"Huang, Z., Zhu, Y., Li, X., Yao, Z. & Ge, R. The mechanisms of metronidazole resistance of Helicobacter pylori: A transcriptomic and biochemical study. Microb. Pathog. 183, 106303 (2023).","journal-title":"Microb. Pathog"},{"issue":"3","key":"16264_CR47","doi-asserted-by":"publisher","first-page":"618","DOI":"10.3390\/antibiotics12030618","volume":"12","author":"S Burayzat","year":"2023","unstructured":"Burayzat, S. et al. Antimicrobial resistance molecular mechanisms of Helicobacter pylori in Jordanian children: a cross-sectional observational study. Antibiot. (Basel) 12 (3), 618 (2023).","journal-title":"Antibiot. (Basel)"},{"issue":"11","key":"16264_CR48","doi-asserted-by":"publisher","first-page":"3152","DOI":"10.1093\/jac\/dkaa302","volume":"75","author":"S Zhang","year":"2020","unstructured":"Zhang, S. et al. Mutations of Helicobacter pylori RdxA are mainly related to the phylogenetic origin of the strain and not to metronidazole resistance. J. Antimicrob. Chemother. 75 (11), 3152\u20133155 (2020).","journal-title":"J. Antimicrob. Chemother."},{"issue":"9","key":"16264_CR49","doi-asserted-by":"publisher","first-page":"2786","DOI":"10.3748\/wjg.v21.i9.2786","volume":"21","author":"YX Zhang","year":"2015","unstructured":"Zhang, Y. X. et al. Primary antibiotic resistance of Helicobacter pylori strains isolated from patients with dyspeptic symptoms in beijing: a prospective serial study. World J. Gastroenterol. 21 (9), 2786\u20132792 (2015).","journal-title":"World J. Gastroenterol."},{"issue":"4","key":"16264_CR50","doi-asserted-by":"publisher","first-page":"e12804","DOI":"10.1111\/hel.12804","volume":"26","author":"SY Li","year":"2021","unstructured":"Li, S. Y. et al. The effect of previous eradication failure on antibiotic resistance of Helicobacter pylori: A retrospective study over 8 years in Beijing. Helicobacter 26 (4), e12804 (2021).","journal-title":"Helicobacter"},{"issue":"Pt 7","key":"16264_CR51","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1099\/jmm.0.009993-0","volume":"58","author":"L Boyanova","year":"2009","unstructured":"Boyanova, L. Prevalence of multidrug-resistant Helicobacter pylori in Bulgaria. J. Med. Microbiol. 58 (Pt 7), 930\u2013935 (2009).","journal-title":"J. Med. Microbiol."},{"issue":"8","key":"16264_CR52","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1097\/00004836-200609000-00004","volume":"40","author":"N Kim","year":"2006","unstructured":"Kim, N. et al. Institutional difference of antibiotic resistance of Helicobacter pylori strains in Korea. J. Clin. Gastroenterol. 40 (8), 683\u2013687 (2006).","journal-title":"J. Clin. Gastroenterol."},{"issue":"12","key":"16264_CR53","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1111\/j.1365-2036.2007.03331.x","volume":"25","author":"A Zullo","year":"2007","unstructured":"Zullo, A. et al. Primary antibiotic resistance in Helicobacter pylori strains isolated in Northern and central Italy. Aliment. Pharmacol. Ther. 25 (12), 1429\u20131434 (2007).","journal-title":"Aliment. Pharmacol. Ther."},{"issue":"37","key":"16264_CR54","doi-asserted-by":"publisher","first-page":"5578","DOI":"10.3748\/wjg.v25.i37.5578","volume":"25","author":"BB de Brito","year":"2019","unstructured":"de Brito, B. B. et al. Pathogenesis and clinical management of Helicobacter pylori gastric infection. World J. Gastroenterol. 25 (37), 5578\u20135589 (2019).","journal-title":"World J. Gastroenterol."},{"issue":"1","key":"16264_CR55","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1186\/s12866-016-0873-6","volume":"16","author":"M Miftahussurur","year":"2016","unstructured":"Miftahussurur, M., Shrestha, P. K., Subsomwong, P., Sharma, R. P. & Yamaoka, Y. Emerging Helicobacter pylori Levofloxacin resistance and novel genetic mutation in Nepal. BMC Microbiol. 16 (1), 256 (2016).","journal-title":"BMC Microbiol."},{"issue":"5","key":"16264_CR56","doi-asserted-by":"publisher","first-page":"e03203-20","DOI":"10.1128\/JCM.03203-20","volume":"59","author":"A Mannion","year":"2021","unstructured":"Mannion, A. et al. Helicobacter pylori antimicrobial resistance and gene variants in high- and low-gastric-cancer-risk populations. J. Clin. Microbiol. 59 (5), e03203-20 (2021).","journal-title":"J. Clin. Microbiol."},{"issue":"4","key":"16264_CR57","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1038\/ajg.2014.24","volume":"109","author":"MC Camargo","year":"2014","unstructured":"Camargo, M. C. et al. The problem of Helicobacter pylori resistance to antibiotics: a systematic review in Latin America. Am. J. Gastroenterol. 109 (4), 485\u2013495 (2014).","journal-title":"Am. J. Gastroenterol."},{"issue":"53","key":"16264_CR58","doi-asserted-by":"publisher","first-page":"2451","DOI":"10.21105\/joss.02451","volume":"5","author":"MJ Sullivan","year":"2020","unstructured":"Sullivan, M. J. & van Bakel, H. Chromatiblock: Scalable whole-genome visualization of structural differences in prokaryotes. J. Open. Source Softw. 5 (53), 2451 (2020).","journal-title":"J. Open. Source Softw."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-16264-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-16264-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-16264-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T21:02:31Z","timestamp":1759698151000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-16264-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,1]]},"references-count":58,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["16264"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-16264-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,1]]},"assertion":[{"value":"31 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"34244"}}