Multicentre, cross-sectional surveillance of Helicobacter pylori prevalence and antibiotic resistance to clarithromycin and levofloxacin in urban China using the string test coupled with quantitative PCR

Antibiotic-resistant Helicobacter pylori infections pose a considerable burden on health care in China.1 However, the existing knowledge of H pylori prevalence and antibiotic resistance in urban China is derived from heterogeneous testing methodologies and studied populations.2 The string test is a minimally invasive method used to obtain gastric fluid samples3,4 and can be used to detect H pylori infection and antibiotic resistance when combined with quantitative PCR (appendix p 3–4).5 We conducted nationwide, multicentre, cross-sectional surveillance using this combined diagnostic approach to provide an overview of H pylori prevalence and antibiotic resistance rates, specifically against clarithromycin and levofloxacin, in urban China.