Global Antimicrobial Resistance Gene Study of Helicobacter pylori: Comparison of Detection Tools, ARG and Efflux Pump Gene Analysis, Worldwide Epidemiological Distribution, and Information Related to the Antimicrobial-Resistant Phenotype

We conducted a global-scale study to identify H. pylori antimicrobial-resistant genes (ARG), address their global distribution, and understand effect on the antimicrobial resistance (AMR) phenotypes of clinical isolates. identified ARG using several well-known tools against extensive bacterial databases, then analyzed correlation with antibiogram data from dozens patients across countries. This revealed that combining multiple followed by manual selection annotation results, produces more conclusive results than single tool or database alone. After curation, showed has 42 11 different antibiotic classes (16 related class 26 multidrug resistance). Further analysis naturally harbors in core genome, called ‘Set commonly found Core Genome (ARG-CORE)’, while ARG-ACC—the accessory genome—are exclusive particular strains. In addition, we detected 29 potential efflux pump-related AMR were mostly categorized as ARG-CORE. The distribution appears be almost similar either geographical populations perspective; however, some had unique since they tend only region population. Finally, demonstrated presence may not directly correlate sensitive/resistance phenotype patient isolates but influence minimum inhibitory concentration phenotype.