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Antibiotics
Special Issues
Helicobacter pylori Virulence Factors, Antibiotic Susceptibility and Persistent Infection
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Helicobacter pylori Virulence Factors, Antibiotic Susceptibility and Persistent Infection

A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: 31 January 2026 | Viewed by 970

Special Issue Editors

Dr. Mara Di Giulio

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Guest Editor
Department of Pharmacy, “G. d’Annunzio” University, 66100 Chieti, Italy
Interests: biofilm; innovative antimicrobial strategies; Helicobacter pylori; chronic wound infections
Special Issues, Collections and Topics in MDPI journals
Dr. Teresa Fasciana

E-Mail Website
Guest Editor
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90133 Palermo, Italy
Interests: gram positive and negative microorganisms; multi drug resistance; H. pylori; natural components and their antibiofilm actions
Special Issues, Collections and Topics in MDPI journals
Dr. Chiara Pagliuca

E-Mail Website
Guest Editor
Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy
Interests: microbial pathogenesis; microbial molecular biology; gut human microbiota; infections model
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The first edition of the Special Issue, entitled “Helicobacter pylori Virulence Factors and Antibiotic Susceptibility”, was published in 2020. It was a successful collection comprising nine excellent papers. This encouraged us to launch a second edition on the same topic.

As a continuation of the first Special Issue, this second edition focuses on state-of-the-art research regarding H. pylori virulence factors together with their effect on gastric tissue and correlation with several symptoms related to H. pylori infection and the relationship with oral/gastric microbiome and chemo-susceptibility. The aim is to better understand the complex relationship between virulence and antibiotic resistance, as well as to investigate the persistent phenotypical forms of H. pylori strains and a possible correlation with virulence factors.

The results of this research may help to develop therapeutical strategies with new combinations of anti-virulence strategies that will allow us to provide more specific and directed drug treatments.

Dr. Mara Di Giulio
Dr. Teresa Fasciana
Dr. Chiara Pagliuca
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Antimicrobial drugs and therapies
  • virulence factors
  • pathogenesis
  • extra-digestive diseases
  • gastric microbioma

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Published Papers (1 paper)

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Research

14 pages, 1218 KB  
Article
Resistance to Clarithromycin and Fluoroquinolones in Helicobacter pylori Isolates: A Prospective Molecular Analysis in Western Romania
by Patricia Serena, Ruxandra Mare, Bogdan Miutescu, Renata Bende, Alexandru Popa, Giovanni Aragona, Edward Seclăman, Luca Serena, Andreea Barbulescu and Roxana Sirli
Antibiotics 2025, 14(12), 1223; https://doi.org/10.3390/antibiotics14121223 - 4 Dec 2025
Viewed by 422
Abstract
Background and Objectives: Helicobacter pylori (H. pylori) infection remains one of the most common chronic bacterial infections worldwide and is associated with a wide range of gastrointestinal disorders, including gastritis, peptic ulcer disease, and gastric cancer. Increasing rates of antibiotic [...] Read more.
Background and Objectives: Helicobacter pylori (H. pylori) infection remains one of the most common chronic bacterial infections worldwide and is associated with a wide range of gastrointestinal disorders, including gastritis, peptic ulcer disease, and gastric cancer. Increasing rates of antibiotic resistance, particularly to clarithromycin and fluoroquinolones, represent a major therapeutic challenge. The objective of this study was to determine the prevalence of resistance-associated mutations in H. pylori-positive gastric biopsy samples from western Romania. Materials and Methods: We conducted a prospective study from January to December 2024, enrolling 138 patients undergoing gastroscopy. Biopsies were collected from the gastric antrum, and H. pylori infection was confirmed using the rapid urease test (RUT). Positive samples were further analyzed with the GenoType HelicoDR assay to detect mutations in the 23S rRNA gene (clarithromycin resistance) and gyrA gene (fluoroquinolone resistance). Clinical, demographic, and endoscopic data were also collected. Results:H. pylori infection was confirmed in 41.3% of the patients (57), of whom 63.2% (36) were treatment-naïve and 36.8% (21) had prior eradication therapy. Among treatment-naïve patients, clarithromycin resistance was identified in 19.4%, whereas previously treated patients showed a markedly higher resistance rate of 47.6% (p = 0.018). All clarithromycin-resistant cases carried the A2147G (23S MUT3) mutation. Fluoroquinolone resistance was present in 13.9% of naïve patients and increased to 23.8% in those with prior eradication therapy, with resistance linked to gyrA mutations at codons 87 (N87K) and 91 (D91 variants). Combined resistance to both antibiotics was observed only in a subset of previously treated patients. Conclusions: Primary resistance to clarithromycin in western Romania exceeds the 15% threshold defined by international guidelines, making clarithromycin-based triple therapy unsuitable as an empirical first-line option. The findings support the use of bismuth quadruple therapy as the preferred empirical regimen in this region. Also, molecular testing proved effective for rapid identification of resistance-associated mutations. Full article
(This article belongs to the Special Issue Helicobacter pylori Virulence Factors, Antibiotic Susceptibility and Persistent Infection)
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