Abstract: Objective To investigate the prevalence of Helicobacter pylori （Hp） infection among adult residents in Wuwei City,Gansu Province,analyze the resistance of Hp strains to commonly used antibiotics,and further explore the correlation between different genotypes of virulence and drug resistance. Methods A multi-stage stratified sampling method was used to select adult residents in Wuwei City,Gansu Province from September to December 2023. The ¹⁴C urea breath test was used to detect Hp infection,and gastric mucosal biopsy samples of Hp infected people were collected to isolate and culture Hp. In addition,the disk diffusion method （K-B method） was used to test the susceptibility of Hp strains to five commonly used antibiotics,and genomic DNA of Hp strain was extracted. The virulence genes （cagA and vacA） of Hp strain were analyzed and detected by polymerase chain reaction （PCR）. Results A total of 1 814 adult residents were included in the survey,including 935 males and 879 females,with an average age of （53.2±9.3） years. The Hp infection rate was 69.63% （1 263/1 814）. There were significant differences in the detection rate of Hp among adult residents with different ages,BMI,levels of education,smoking and drinking habits,irregular meal patterns,and dietary preferences （P<0.05 or P<0.01）. A total of 1 242 Hp strains were isolated from Hp infected patients,and the resistance rates to five commonly used antibiotics were metronidazole （70.29%）,levofloxacin （50.56%）,clarithromycin （33.41%）,tetracycline （9.02%）,and amoxicillin （5.56%）,respectively. Single drug resistance （55.80%） was the main strain,followed by double drug resistance （21.74%） and triple drug resistance （7.33%）. The PCR results revealed that the positivity rate of cagA was 83.57%. Additionally,the genotype of vacAs was found to be 78.66% for s1,55.15% for m2,and 65.38% for i1. The resistance rate of Hp strain carrying vacA s1m1m2 to metronidazole was significantly higher than that of vacA s1m1/m2 （P<0.01）. Furthermore,it was noted that the resistance rate of levofloxacin in cagA⁺ type was significantly higher than that in cagA^- type （P<0.05）. Conclusions The infection rate of Hp was found to be high in Wuwei City,Gansu Province,and there was a significant variation in drug resistance among different Hp strains as determined by molecular subtyping. Therefore,it is recommended that eradication therapy for Hp in this region should be tailored based on historical data,the drug resistance profiles of commonly used antibiotics,and genotype test results.

Key words: Helicobacter pylori, Infection, Drug resistance analysis, Virulence genes, Molecular subtyping