A single-center culture-based study of Helicobacter pylori in Kazakhstan with regional meta-analysis of prevalence and antibiotic resistance
Dauyey K. Zhunussova G. Kaibullayeva J. Bondar Y. Yerzhan A. Medetbekova A. Kaisina A. Khabizhanova A. Seitbekov K. Yamaoka Y.
2026Frontiers Media SA
Frontiers in Microbiology
2026#17
Background: Helicobacter pylori (H. pylori) is a major gastric pathogen and class I carcinogen that causes chronic gastritis, peptic ulcer, and gastric cancer if left untreated. However, evidence on H. pylori prevalence and antimicrobial resistance in Kazakhstan, a country with a high gastric cancer burden, remains scarce. This study presents the first culture-based epidemiological investigation of H. pylori at a single center in Almaty. Materials and methods: We conducted a cross-sectional study (2024–2025) of 150 dyspeptic patients in Almaty, Kazakhstan. A subset (n = 148) underwent rapid stool antigen (RAS) testing before gastric biopsy collection. Biopsy samples were cultured, and 86 (57.3%) yielded viable H. pylori isolates. Antimicrobial susceptibility testing by the agar dilution method was performed on these 86 isolates. Demographic and clinical data were analyzed, and a regional meta-analysis was conducted using data from recent studies across Central Asia and Russia to estimate pooled prevalence and clarithromycin resistance. Results: Among 148 patients tested by RAS, 137 were positive. Resistance rates among 86 isolates were 87.2% to metronidazole, 33.7% to clarithromycin, and 3.5% to amoxicillin; no resistance was detected to minocycline or sitafloxacin. Multidrug resistance (defined as resistance to two or more antibiotics) was observed in 34.8% of isolates. The pooled H. pylori prevalence across Central Asian studies was 70% (95% CI: 59–80%), and pooled clarithromycin resistance was 29% (95% CI: 10–53%). Conclusion: This study provides the first culture-based evidence of H. pylori infection and antimicrobial resistance in Kazakhstan. The high resistance to metronidazole and clarithromycin suggests a likely lower success of standard triple therapy in Almaty. Absence of resistance to minocycline and sitafloxacin supports their use in rescue regimens. These findings highlight the urgent need for national surveillance, updated treatment guidelines, and integration of molecular resistance monitoring to improve evidence-based management of H. pylori in Central Asia. Copyright
antimicrobial susceptibility test , Helicobacter pylori , Kazakhstan , meta-analysis , prevalence
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Laboratory of Molecular Genetics, RSE Institute of Genetics and Physiology of the SC MSHE RK, Almaty, Kazakhstan
Scientific-Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu, Japan
Research Center for Global and Local Infectious Diseases, Oita University, Yufu, Japan
Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX, United States
Laboratory of Molecular Genetics
Scientific-Research Institute of Cardiology and Internal Diseases
Department of Environmental and Preventive Medicine
Research Center for Global and Local Infectious Diseases
Department of Medicine
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