{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T03:55:05Z","timestamp":1792900505059,"version":"4.5.0"},"reference-count":29,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T00:00:00Z","timestamp":1700784000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan","award":["18KK0266"],"award-info":[{"award-number":["18KK0266"]}]},{"name":"Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan","award":["19H03473"],"award-info":[{"award-number":["19H03473"]}]},{"name":"Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan","award":["21H00346"],"award-info":[{"award-number":["21H00346"]}]},{"name":"Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan","award":["22H02871"],"award-info":[{"award-number":["22H02871"]}]},{"name":"Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan","award":["17K09353"],"award-info":[{"award-number":["17K09353"]}]},{"name":"Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan","award":["21K07898"],"award-info":[{"award-number":["21K07898"]}]},{"name":"Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan","award":["18K16182"],"award-info":[{"award-number":["18K16182"]}]},{"name":"Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan","award":["21K08010"],"award-info":[{"award-number":["21K08010"]}]},{"name":"Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan","award":["2021B13"],"award-info":[{"award-number":["2021B13"]}]},{"name":"Research Center for GLOBAL and LOCAL Infectious Diseases, Oita University","award":["18KK0266"],"award-info":[{"award-number":["18KK0266"]}]},{"name":"Research Center for GLOBAL and LOCAL Infectious Diseases, Oita University","award":["19H03473"],"award-info":[{"award-number":["19H03473"]}]},{"name":"Research Center for GLOBAL and LOCAL Infectious Diseases, Oita University","award":["21H00346"],"award-info":[{"award-number":["21H00346"]}]},{"name":"Research Center for GLOBAL and LOCAL Infectious Diseases, Oita University","award":["22H02871"],"award-info":[{"award-number":["22H02871"]}]},{"name":"Research Center for GLOBAL and LOCAL Infectious Diseases, Oita University","award":["17K09353"],"award-info":[{"award-number":["17K09353"]}]},{"name":"Research Center for GLOBAL and LOCAL Infectious Diseases, Oita University","award":["21K07898"],"award-info":[{"award-number":["21K07898"]}]},{"name":"Research Center for GLOBAL and LOCAL Infectious Diseases, Oita University","award":["18K16182"],"award-info":[{"award-number":["18K16182"]}]},{"name":"Research Center for GLOBAL and LOCAL Infectious Diseases, Oita University","award":["21K08010"],"award-info":[{"award-number":["21K08010"]}]},{"name":"Research Center for GLOBAL and LOCAL Infectious Diseases, Oita University","award":["2021B13"],"award-info":[{"award-number":["2021B13"]}]},{"name":"Japanese Government (Monbukagakusho: MEXT) Scholarship Programs for 2020 and 2019","award":["18KK0266"],"award-info":[{"award-number":["18KK0266"]}]},{"name":"Japanese Government (Monbukagakusho: MEXT) Scholarship Programs for 2020 and 2019","award":["19H03473"],"award-info":[{"award-number":["19H03473"]}]},{"name":"Japanese Government (Monbukagakusho: MEXT) Scholarship Programs for 2020 and 2019","award":["21H00346"],"award-info":[{"award-number":["21H00346"]}]},{"name":"Japanese Government (Monbukagakusho: MEXT) Scholarship Programs for 2020 and 2019","award":["22H02871"],"award-info":[{"award-number":["22H02871"]}]},{"name":"Japanese Government (Monbukagakusho: MEXT) Scholarship Programs for 2020 and 2019","award":["17K09353"],"award-info":[{"award-number":["17K09353"]}]},{"name":"Japanese Government (Monbukagakusho: MEXT) Scholarship Programs for 2020 and 2019","award":["21K07898"],"award-info":[{"award-number":["21K07898"]}]},{"name":"Japanese Government (Monbukagakusho: MEXT) Scholarship Programs for 2020 and 2019","award":["18K16182"],"award-info":[{"award-number":["18K16182"]}]},{"name":"Japanese Government (Monbukagakusho: MEXT) Scholarship Programs for 2020 and 2019","award":["21K08010"],"award-info":[{"award-number":["21K08010"]}]},{"name":"Japanese Government (Monbukagakusho: MEXT) Scholarship Programs for 2020 and 2019","award":["2021B13"],"award-info":[{"award-number":["2021B13"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Helicobacter pylori is a pathogen related to severe diseases such as gastric cancer; because of rising antimicrobial-resistant strains, failure to eradicate H. pylori with antibiotics has increased worldwide. Multidrug-resistant H. pylori and gastric cancer is common in Mongolia; therefore, we aimed to explore alternative antimicrobial treatments and the genomes of resistant strains in this country. A total of 361 H. pylori strains isolated from patients in Mongolia were considered. Minimal inhibitory concentrations for two fluoroquinolones (ciprofloxacin and moxifloxacin), rifabutin, and furazolidone were determined via two-fold agar dilution. Genomic mutations in antibiotic-resistant strains were identified by next-generation sequencing using the Illumina Miseq platform and compared with genes from a reference H. pylori strain (26695). The resistance rate of H. pylori strains to quinolones was high (44% to ciprofloxacin and 42% to moxifloxacin), and resistance to rifabutin was low (0.5%); none were resistant to furazolidone. Most quinolone-resistant strains possessed gyrA gene mutations causing amino acid changes (e.g., N87K, A88P, and D91G\/Y\/N). While one rifabutin-resistant strain had amino acid-substituting mutations in rpoB (D530N and R701C), the other had three novel rpoB mutations; both rifabutin-resistant strains were sensitive to furazolidone. Overall, our findings suggest that rifabutin and\/or furazolidone may be an alternative, effective H. pylori treatment in patients who have failed to respond to other treatment regimens.<\/jats:p>","DOI":"10.3390\/microorganisms11122852","type":"journal-article","created":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T03:43:59Z","timestamp":1700797439000},"page":"2852","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Exploring Alternative Treatment Choices for Multidrug-Resistant Clinical Strains of Helicobacter pylori in Mongolia"],"prefix":"10.3390","volume":"11","author":[{"given":"Ayush","family":"Khangai","sequence":"first","affiliation":[{"name":"Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu 879-5593, Japan"},{"name":"The Gastroenterology Center, The First Central Hospital of Mongolia, Ulaanbaatar 14210, Mongolia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3258-4453","authenticated-orcid":false,"given":"Batsaikhan","family":"Saruuljavkhlan","sequence":"additional","affiliation":[{"name":"Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu 879-5593, Japan"},{"name":"Endoscopy Unit, Department of Gastroenterology, Mongolia Japan Hospital of Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dashdorj","family":"Azzaya","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boldbaatar","family":"Gantuya","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Department of Gastroenterology, Mongolia Japan Hospital of Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khasag","family":"Oyuntsetseg","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Department of Gastroenterology, Mongolia Japan Hospital of Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2663-9358","authenticated-orcid":false,"given":"Junko","family":"Akada","sequence":"additional","affiliation":[{"name":"Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu 879-5593, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu 879-5593, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1222-5819","authenticated-orcid":false,"given":"Yoshio","family":"Yamaoka","sequence":"additional","affiliation":[{"name":"Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu 879-5593, Japan"},{"name":"Division of Gastroentero-Hepatology, Department of Internal Medicine, Faculty of Medicine-Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya 60115, Indonesia"},{"name":"Research Center for GLOBAL and LOCAL Infectious Diseases, Oita University, Yufu 879-5593, Japan"},{"name":"Department of Medicine-Gastroenterology, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1053\/j.gastro.2018.07.007","article-title":"Prevalence of Antibiotic Resistance in Helicobacter pylori: A Systematic Review and Meta-analysis in World Health Organization Regions","volume":"155","author":"Savoldi","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1038\/nrgastro.2017.57","article-title":"Helicobacter pylori infection and antibiotic resistance: A WHO high priority?","volume":"14","author":"Dang","year":"2017","journal-title":"Nat. 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