{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T15:35:46Z","timestamp":1790004946347,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,6,13]],"date-time":"2018-06-13T00:00:00Z","timestamp":1528848000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007225","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["MOST 104\u20102314\u2010B\u2010075B\u2010001\u2010MY2"],"award-info":[{"award-number":["MOST 104\u20102314\u2010B\u2010075B\u2010001\u2010MY2"]}],"id":[{"id":"10.13039\/100007225","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Bismuth quadruple therapy is the treatment of choice for the first\u2010line therapy of <jats:italic>Helicobacter pylori<\/jats:italic> infection in areas of high clarithromycin resistance. Currently, the impact of the promising treatment on gut microbiota remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate the short\u2010term and long\u2010term impacts of bismuth quadruple therapy on gut microbiota.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult patients with <jats:italic>H.\u00a0pylori<\/jats:italic>\u2010related gastritis were treated with 14\u2010day bismuth quadruple therapy. Fecal samples were collected before treatment at week 2, week 8, and week 48. Nucleic acid extraction from fecal samples was performed. The V3\u2010V4 region of the bacterial <jats:italic>16S <jats:styled-content style=\"fixed-case\">rRNA<\/jats:styled-content><\/jats:italic> gene was amplified by polymerase chain reaction and sequenced with the MiSeq followed by data analysis using Qiime pipeline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven patients received complete follow\u2010up. Before treatment, the most abundant phyla were Firmicutes (45.3%), Bacteroidetes (24.3%), Proteobacteria (9.9%), and Actinobacteria (5.0%). At the end of bismuth therapy, the relative abundances of Bacteroidetes and Actinobacteria decreased to 0.5% (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and 1.3% (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.038), respectively. Additionally, the relative abundance of Verrucomicrobia also decreased from 3.2% to 1.11E\u22123% (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.034). In contrast, the relative abundances of Proteobacteria and Cyanobacteria increased (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>.001 and <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.003, respectively). At week 8, the relative abundances of all phyla restored to the levels at baseline. The relative abundances of all phyla at week 48 also did not significantly differ from those at baseline. During eradication therapy, 6 patients (55%) reported at least 1 adverse event. The relative abundance of phylum Proteobacteria in patients with adverse effects was more than that in patients without adverse effects (68.7%\u00a0\u00b1\u00a08.8% vs 43.4%\u00a0\u00b1\u00a025.5%; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.048).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Bismuth quadruple therapy for <jats:italic>H.\u00a0pylori<\/jats:italic> eradication can lead to short\u2010term dysbiosis of gut microbiota. The increase in Proteobacteria in gut microbiota may attribute to the development of adverse effects during bismuth quadruple therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.12498","type":"journal-article","created":{"date-parts":[[2018,6,15]],"date-time":"2018-06-15T15:11:39Z","timestamp":1529075499000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":94,"title":["<i>Helicobacter pylori<\/i> eradication with bismuth quadruple therapy leads to dysbiosis of gut microbiota with an increased relative abundance of Proteobacteria and decreased relative abundances of Bacteroidetes and Actinobacteria"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3905-4674","authenticated-orcid":false,"given":"Ping\u2010I","family":"Hsu","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Kaohsiung Veterans General Hospital and National Yang\u2010Ming University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao\u2010Yu","family":"Pan","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Informatics National Yang\u2010Ming University and Institute of Biomedical Sciences Academia Sinica  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Y.","family":"Kao","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Division of Gastroenterology Michigan Medicine University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng\u2010Woei","family":"Tsay","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Kaohsiung Veterans General Hospital and National Yang\u2010Ming University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan\u2010Jing","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Kaohsiung Veterans General Hospital and National Yang\u2010Ming University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung\u2010Shuo","family":"Kao","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Kaohsiung Veterans General Hospital and National Yang\u2010Ming University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huay\u2010Min","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Kaohsiung Veterans General Hospital and National Yang\u2010Ming University  Kaohsiung 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