{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:26:41Z","timestamp":1782487601148,"version":"3.54.5"},"reference-count":69,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T00:00:00Z","timestamp":1690416000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Antibiotic resistance of <jats:italic>Helicobacter pylori (H.\u2009pylori)<\/jats:italic> is increasing worldwide, with geographical variations, impacting the treatment outcomes. This study assessed the antibiotic resistance patterns of <jats:italic>H.\u2009pylori<\/jats:italic> in Vietnamese children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Symptomatic children undergoing gastroduodenoscopy at two tertiary Children's Hospitals in Ho Chi Minh City were recruited. Antral and corpus biopsies were obtained and cultured separately. Susceptibility to amoxicillin (AMO), clarithromycin (CLA), metronidazole (MET), levofloxacin (LEV), and tetracycline (TET) was determined using E\u2010test. Polymerase chain reaction was performed on another antral biopsy to detect the urease gene, cytotoxin\u2010associated gene A (<jats:italic>cagA<\/jats:italic>), vacuolating cytotoxin A (<jats:italic>vacA<\/jats:italic>) genotypes, and 23S rRNA mutations conferring CLA resistance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 123 enrolled children, a high primary resistance rate was found for CLA (68.5%, 61\/89), followed by LEV (55.1%), MET (31.5%), AMO (25.8%), and TET (1.1%). Secondary resistance rates were 82.1% (7\/28), 71.4%, 53.6%, and 3.6% for CLA, LEV, MET, and TET, respectively. Multidrug resistance was frequent (67.7%), with common patterns including CLA\u2009+\u2009LEV (20.3%) and CLA\u2009+\u2009MTZ\u2009+\u2009LEV (15.2%). Heteroresistance was detected in eight children (6.5%). The A2143G mutation was detected in 97.5% (119\/122) of children. 86.1% of children had positive <jats:italic>cagA<\/jats:italic> strains and 27.9% had multiple <jats:italic>vacA<\/jats:italic> genotypes. No factor was significantly associated with antibiotic resistance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The alarming rate of antibiotic resistance for <jats:italic>H.\u2009pylori<\/jats:italic>, especially for CLA, with emerging multi\u2010 and hetero\u2010resistant strains, pose a major treatment challenge that precludes CLA use as empirical therapy. Biopsies from both antrum and corpus can improve <jats:italic>H.\u2009pylori<\/jats:italic> culture, allowing tailored treatment based on antimicrobial susceptibility.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.13009","type":"journal-article","created":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T10:58:49Z","timestamp":1690455529000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Antibiotic resistance and heteroresistance in <i>Helicobacter pylori<\/i> isolates from symptomatic Vietnamese children: A prospective multicenter study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8497-3739","authenticated-orcid":false,"given":"Tu Cam","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology City Children's Hospital  Ho Chi Minh City Vietnam"},{"name":"Faculty of Medicine Universit\u00e9 Libre de Bruxelles  Brussels 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