---
title: "High multidrug resistance in Helicobacter pylori isolates from Egyptian gastric biopsies"
id: "pubmed-42909629"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42909629"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42909629/"
doi: "10.1007/s00203-026-05252-3"
published_at: "2026-10-23T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# High multidrug resistance in Helicobacter pylori isolates from Egyptian gastric biopsies
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42909629
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42909629/)
- **DOI:** [10.1007/s00203-026-05252-3](https://doi.org/10.1007%2Fs00203-026-05252-3)
- **Published At:** 2026-10-23T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The study cultured gastric biopsies from 60 Egyptian patients undergoing upper GI endoscopy; **H. pylori** was isolated from 20 patients. - Investigators used culture under microaerophilic conditions and conventional phenotypic identification methods; antimicrobial susceptibility was measured by the disk-diffusion method against commonly prescribed antibiotics. - All 20 isolates (100%) met the study definition of multidrug resistance (**MDR**); 90% were resistant to both **clarithromycin** and **amoxicillin**. - The cohort showed statistically significant associations between culture positivity and clinical diagnoses of gastritis (p = 0.002) and gastric ulcer (p = 0.035). - Higher isolation rates appeared among male patients and those aged ≥ 60 years, but sex and age were not significantly associated with multidrug resistance (p > 0.05). - Authors reported the findings as evidence of an alarming MDR prevalence and recommended continuous antimicrobial resistance surveillance and susceptibility-guided eradication strategies. - The abstract did not provide detailed susceptibility breakpoints, disk-diffusion interpretive criteria, full antibiotic panel results beyond clarithromycin and amoxicillin percent resistance, or molecular resistance mechanisms; those methodological specifics were not reported in the source.
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Affiliations Expand ### Affiliations * 1 Botany and Microbiology Department, Faculty of Science, Benha University, Benha, 13518, Egypt. asmaa180085@fsc.bu.edu.eg. * 2 Microbiology and Immunology Department, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt. * 3 Biology Department, College of Science, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, 11623, Saudi Arabia. * 4 Radiation Microbiology Department, National Center for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority (EAEA), Cairo, Egypt. * 5 Hepatogastroenterology and Infectious Diseases Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. * 6 Botany and Microbiology Department, Faculty of Science, Benha University, Benha, 13518, Egypt. * 7 Botany and Microbiology Department, Faculty of Science, Benha University, Benha, 13518, Egypt. mervat.hassan@fsc.bu.edu.eg. * PMID: **42909629** * DOI: [ 10.1007/s00203-026-05252-3 ](https://doi.org/10.1007/s00203-026-05252-3) Item in Clipboard # Alarmingly high multidrug resistance among Helicobacter pylori isolates from gastric biopsies in Egypt: phenotypic characterization and clinical correlation Asmaa K Abdallah et al. Arch Microbiol. 2026. Show details Display options Display options Format Abstract PubMed PMID Arch Microbiol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Arch+Microbiol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Arch+Microbiol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42909629/) . 2026 Oct 23;209(1):30. doi: 10.1007/s00203-026-05252-3. ### Authors [Asmaa K Abdallah](https://pubmed.ncbi.nlm.nih.gov/?term=Abdallah+AK&cauthor_id=42909629)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42909629/#short-view-affiliation-1 "Botany and Microbiology Department, Faculty of Science, Benha University, Benha, 13518, Egypt. asmaa180085@fsc.bu.edu.eg."), [Mohammed S Abdulrahman](https://pubmed.ncbi.nlm.nih.gov/?term=Abdulrahman+MS&cauthor_id=42909629)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42909629/#short-view-affiliation-2 "Microbiology and Immunology Department, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt."), [Gharieb S El-Sayyad](https://pubmed.ncbi.nlm.nih.gov/?term=El-Sayyad+GS&cauthor_id=42909629)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42909629/#short-view-affiliation-3 "Biology Department, College of Science, Imam Mohammad Ibn Saud Islamic University \(IMSIU\), Riyadh, 11623, Saudi Arabia."), [Doaa A Emam](https://pubmed.ncbi.nlm.nih.gov/?term=Emam+DA&cauthor_id=42909629)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42909629/#short-view-affiliation-4 "Radiation Microbiology Department, National Center for Radiation Research and Technology \(NCRRT\), Egyptian Atomic Energy Authority \(EAEA\), Cairo, Egypt."), [Samy Zaky](https://pubmed.ncbi.nlm.nih.gov/?term=Zaky+S&cauthor_id=42909629)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42909629/#short-view-affiliation-5 "Hepatogastroenterology and Infectious Diseases Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt."), [Mohamed O Abdel-Monem](https://pubmed.ncbi.nlm.nih.gov/?term=Abdel-Monem+MO&cauthor_id=42909629)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42909629/#short-view-affiliation-6 "Botany and Microbiology Department, Faculty of Science, Benha University, Benha, 13518, Egypt."), [Mervat G Hassan](https://pubmed.ncbi.nlm.nih.gov/?term=Hassan+MG&cauthor_id=42909629)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42909629/#short-view-affiliation-7 "Botany and Microbiology Department, Faculty of Science, Benha University, Benha, 13518, Egypt. mervat.hassan@fsc.bu.edu.eg.") ### Affiliations * 1 Botany and Microbiology Department, Faculty of Science, Benha University, Benha, 13518, Egypt. asmaa180085@fsc.bu.edu.eg. * 2 Microbiology and Immunology Department, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt. * 3 Biology Department, College of Science, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, 11623, Saudi Arabia. * 4 Radiation Microbiology Department, National Center for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority (EAEA), Cairo, Egypt. * 5 Hepatogastroenterology and Infectious Diseases Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. * 6 Botany and Microbiology Department, Faculty of Science, Benha University, Benha, 13518, Egypt. * 7 Botany and Microbiology Department, Faculty of Science, Benha University, Benha, 13518, Egypt. mervat.hassan@fsc.bu.edu.eg. * PMID: **42909629** * DOI: [ 10.1007/s00203-026-05252-3 ](https://doi.org/10.1007/s00203-026-05252-3) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract Helicobacter pylori (H. pylori) infection is a major cause of chronic gastritis, peptic ulcer disease, and gastric cancer, while increasing antimicrobial resistance has become a major challenge to successful eradication. This study investigated the phenotypic antimicrobial susceptibility patterns of H. pylori isolates from Egyptian patients and evaluated their associations with clinical characteristics. Gastric biopsy specimens were collected from 60 patients undergoing upper gastrointestinal endoscopy. H. pylori was isolated by culture under microaerophilic conditions and identified using conventional phenotypic methods. Antimicrobial susceptibility was assessed by the disk diffusion method against commonly prescribed antibiotics. H. pylori was successfully isolated from 20 of 60 patients. Gastritis and gastric ulcer were significantly associated with culture positivity (p = 0.002 and p = 0.035, respectively), whereas no significant associations were observed for other clinical manifestations. All isolates (100%) were multidrug-resistant (MDR), and 90% were resistant to both clarithromycin and amoxicillin. Although higher isolation rates were observed among male patients and those aged ≥ 60 years, neither sex nor age was significantly associated with multidrug resistance (p > 0.05). These findings demonstrate an alarming prevalence of MDR H. pylori isolates in Egypt, emphasizing the need for continuous antimicrobial resistance surveillance and susceptibility-guided eradication strategies to improve treatment outcomes. **Keywords:** H. pylori; Clarithromycin; Egypt; Gastric biopsy; Gastritis; MDR; Phenotypic methods. © 2026. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declarations. Competing interests: The authors declare no competing interests. Ethical approval and consent to participate: Written informed consent was obtained from all participants at Al-Zahraa Hospital, Cairo, and from the Research Ethics Committee of the National Center for Radiation Research and Technology (NCRRT), under approval number F/4H/24. ## References 1. 1. Abdulrahman MS et al (2024) PCR-based RFLP and ERIC-PCR patterns of Helicobacter pylori strains linked to multidrug resistance in Egypt. Sci Rep 14(1):22273 - [DOI](https://doi.org/10.1038/s41598-024-72289-z) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/39333134/) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/11436738/) 2. 1. Acke S et al (2022) Global infectious disease risks associated with occupational exposure among non-healthcare workers: a systematic review of the literature. Occup Environ Med 79(1):63–71 - [DOI](https://doi.org/10.1136/oemed-2020-107164) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/34035182/) 3. 1. Akhtereeva A et al (2018) Antibiotic susceptibility assessment of Helicobacter pylori isolates by disk-diffusion method. BioNanoScience 8(3):930–934 - [DOI](https://doi.org/10.1007/s12668-018-0527-2) 4. 1. Ali A, AlHussaini KI (2024) Helicobacter pylori: a contemporary perspective on pathogenesis, diagnosis and treatment strategies. Microorganisms 12(1):222 - [DOI](https://doi.org/10.3390/microorganisms12010222) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/38276207/) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/10818838/) 5. 1. Ansari S, Yamaoka Y (2022) Helicobacter pylori infection, its laboratory diagnosis, and antimicrobial resistance: a perspective of clinical relevance. Clin Microbiol Rev 35(3):e00258–e00221 - [DOI](https://doi.org/10.1128/cmr.00258-21) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/35404105/) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/9491184/) Show all 48 references ## MeSH terms * Adult Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Adult%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Adult) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42909629/) * Aged Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Aged%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Aged) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42909629/) * Amoxicillin / pharmacology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Amoxicillin%2Fpharmacology%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Amoxicillin) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42909629/) * Anti-Bacterial Agents* / pharmacology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Anti-Bacterial+Agents%2Fpharmacology%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Anti-Bacterial+Agents) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42909629/) * Biopsy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Biopsy%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Biopsy) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42909629/) * Clarithromycin / pharmacology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Clarithromycin%2Fpharmacology%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Clarithromycin) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42909629/) * Drug Resistance, Multiple, Bacterial* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Drug+Resistance%2C+Multiple%2C+Bacterial%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Drug+Resistance%2C+Multiple%2C+Bacterial) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42909629/) * Egypt / epidemiology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Egypt%2Fepidemiology%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Egypt) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42909629/) * Female Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Female) * [ Add to Search ](https://pubmed.ncbi.nlm.ni
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