{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:09:17Z","timestamp":1790737757498,"version":"4.1.0"},"reference-count":59,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T00:00:00Z","timestamp":1595548800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["221S0002"],"award-info":[{"award-number":["221S0002"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["16H06279"],"award-info":[{"award-number":["16H06279"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["18KK0266"],"award-info":[{"award-number":["18KK0266"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["19H03473"],"award-info":[{"award-number":["19H03473"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["18K16182"],"award-info":[{"award-number":["18K16182"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["Institutional Program for Young Researcher Overseas Visits and the Strategic Funds for the Promotion of Science and Technology Agency (JST)"],"award-info":[{"award-number":["Institutional Program for Young Researcher Overseas Visits and the Strategic Funds for the Promotion of Science and Technology Agency (JST)"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"name":"World Class Professor Program 2018","award":["no. 123.4\/D2.3\/KP\/2018"],"award-info":[{"award-number":["no. 123.4\/D2.3\/KP\/2018"]}]},{"name":"Hibah Riset Mandat Universitas Airlangga","award":["340\/UN3.14\/LT\/2019"],"award-info":[{"award-number":["340\/UN3.14\/LT\/2019"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>We evaluated biofilm formation of clinical Helicobacter pylori isolates from Indonesia and its relation to antibiotic resistance. We determined the minimum inhibition concentration (MIC) of amoxicillin, clarithromycin, levofloxacin, metronidazole and tetracycline by the Etest to measure the planktonic susceptibility of 101 H. pylori strains. Biofilms were quantified by the crystal violet method. The minimum biofilm eradication concentration (MBEC) was obtained by measuring the survival of bacteria in a biofilm after exposure to antibiotics. The majority of the strains formed a biofilm (93.1% (94\/101)), including weak (75.5%) and strong (24.5%) biofilm-formers. Planktonic resistant and sensitive strains produced relatively equal amounts of biofilms. The resistance proportion, shown by the MBEC measurement, was higher in the strong biofilm group for all antibiotics compared to the weak biofilm group, especially for clarithromycin (p = 0.002). Several cases showed sensitivity by the MIC measurement, but resistance according to the MBEC measurements (amoxicillin, 47.6%; tetracycline, 57.1%; clarithromycin, 19.0%; levofloxacin, 38.1%; and metronidazole 38.1%). Thus, biofilm formation may increase the survival of H. pylori and its resistance to antibiotics. Biofilm-related antibiotic resistance should be evaluated with antibiotic susceptibility.<\/jats:p>","DOI":"10.3390\/toxins12080473","type":"journal-article","created":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T11:16:35Z","timestamp":1595589395000},"page":"473","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Biofilm Formation and Antibiotic Resistance Phenotype of Helicobacter pylori Clinical Isolates"],"prefix":"10.3390","volume":"12","author":[{"given":"Kartika Afrida","family":"Fauzia","sequence":"first","affiliation":[{"name":"Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu 879-5593, Japan"},{"name":"Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Miftahussurur","sequence":"additional","affiliation":[{"name":"Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia"},{"name":"Division of Gastroentero-Hepatology, Department of Internal Medicine, Faculty of Medicine-Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari Fahrial","family":"Syam","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Langgeng Agung","family":"Waskito","sequence":"additional","affiliation":[{"name":"Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia"},{"name":"Division of Gastroentero-Hepatology, Department of Internal Medicine, Faculty of Medicine-Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalla","family":"Doohan","sequence":"additional","affiliation":[{"name":"Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu 879-5593, Japan"},{"name":"Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7600-9114","authenticated-orcid":false,"given":"Yudith Annisa Ayu","family":"Rezkitha","sequence":"additional","affiliation":[{"name":"Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia"},{"name":"Department of Internal Medicine, Faculty of Medicine, Universitas Muhammadiyah Surabaya, Surabaya 60113, Indonesia"}],"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\/0000-0001-9704-1367","authenticated-orcid":false,"given":"Vo Phuoc","family":"Tuan","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":"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":"Hideo","family":"Yonezawa","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeru","family":"Kamiya","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, 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":"Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX 77030, USA"},{"name":"Global Oita Medical Advanced Research Center for Health (GO-MARCH), Yufu 879-5593, Japan"},{"name":"Borneo Medical and Health Research Centre, University Malaysia Sabah, Kota Kinabalu, Sabah 88400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Savoldi, A., Carrara, E., Graham, P.D.Y., Conti, M., and Tacconelli, E. 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