广东珠海地区幽门螺杆菌对常用抗菌药物的体外耐药情况In vitro drug resistance of Helicobacter pylori strain isolated from patients to commonly used antibacterial drugs in Zhuhai area
卫金歧;农高惠;陈美竹;丛云燕;伍百贺;黄雪平;
摘要(Abstract):
目的了解广东珠海地区幽门螺杆菌(Hp)对常用抗菌药物的耐药情况,为临床规范化根除Hp提供理论依据。方法①内镜下于胃窦钳取1块黏膜进行快速尿素酶试验,阳性者再钳取1块黏膜行细菌培养。②Hp培养及鉴定:采用固体培养基分离培养及液体培养基扩增Hp菌株,经动力试验,革兰染色,生化试验包括尿素酶、过氧化氢酶、氧化酶试验鉴定为Hp菌株。③抗生素药敏试验:采用折点敏感试验方法测定Hp对5种不同抗菌药物的耐药情况。结果 Hp培养阳性率为30.4%(95/312);广东珠海地区Hp对5种抗菌药物甲硝唑、呋喃唑酮、阿莫西林、克拉霉素、左氧氟沙星的耐药率分别为88.4%(84/95)、61.1%(58/95)、47.4%(45/95)、42.1%(40/95)、21.1%(20/95)。Hp耐药率在性别、年龄、疾病类型间的差异无统计学意义(P>0.05)。结论 5种抗菌药物耐药率均较高,其中甲硝唑耐药率最高,左氧氟沙星耐药率最低。
关键词(KeyWords): 幽门螺杆菌;耐药;抗菌药物;甲硝唑;呋喃唑酮;阿莫西林;克拉霉素
基金项目(Foundation): 广东省珠海市科技工贸和信息化局项目(编号2011B040102006)
作者(Authors): 卫金歧;农高惠;陈美竹;丛云燕;伍百贺;黄雪平;
DOI: 10.19577/j.cnki.issn10074406.2013.04.009
参考文献(References):
- [1]J Rhead JL,Letley DP,Mohammadi M,et a1.A new Helicobacter pylori vaeuolating cytotoxin determinant,the intermediate region,is associated with gastric cancer[J].Gastroenterology,2007,133(3):926.
- [2]高文,胡伏莲.幽门螺杆菌感染与胃肠外疾病的关系[J].医学与哲学:临床决策论坛版,2007,28(6):17.
- [3]胡伏莲.幽门螺杆菌根除失败的原因分析和处理策略[J].现代消化及介入诊疗,2010(2):108.
- [4]中华医学会消化病学分会幽门螺杆菌学组/幽门螺杆菌科研协作组,成虹,胡伏莲,等.中国幽门螺杆菌耐药状况以及耐药对治疗的影响——全国多中心临床研究[J].胃肠病学,2007,12(9):525.
- [5]黄宏思,黄衍强,黄赞松,等.胃溃疡及胃炎患者幽门螺杆菌耐药性分析[J].中国公共卫生,2010,26(1):59.
- [6]林永辉,杨行堂,张丽,等.HP临床分离株对5种抗生素的耐药性分析[J].同济大学学报(医学版),2009,30(5):86.
- [7]Sasaki M,Ogasawar N,Utmmi K,et a1.alanges in l2-yearfirst-llne eradcation rate of Helicobacter pylori based on triple therapy with proton pump inhibitor,anacicillin and clarithnmaycin[J].J Clin Bioehem Nutr,2010,47(1):53.
- [8]吕农华,祝荫.幽门螺杆菌耐药的现状与对策[J].中华消化杂志,2011,31(1):66.
- [9]Boyanova L,Mitov I.Geographic map and evolution of primary Hellcobater pylori ressistamce of antibacterial agents[J].Expert Rev Anti Infeet Ther,2010,8(1):59.
- [10]蔡跃芳,陈立群,尹玲,等.东莞市幽门螺杆菌耐药状况临床研究[J].当代医学,2010,16(24):90.
- [11]曹春宇,金海,汤武亨,等.舟山群岛地区幽门螺杆菌耐药情况临床研究[J].实用医学杂志,2008(6):967.
- [12]杨行堂,张俊杰,张旖晴,等.幽门螺杆菌临床分离株耐药特点分析[J].世界华人消化杂志,2007,15(9):1012.
- [13]王艳,周惠琴,唐文.苏州市胃肠病患者幽门螺旋杆菌耐药分析[J].中国公共卫生,2010,26(1):122.
- [14]Duck WM,Sobel J,Pmckler JM,et a1.Antimierobial resistanceincidence and risk factors among Hdicobacter pylori-infeeted persons,United States[J].Emerg Infeet Dis,2004,10(6):1088.
- [15]Mcmahon BJ,Hennessy TW,Bensler JM,et a1.The relationship among previous antimicrobial use,antimicrobial resistance,and treatment outeomer for Helicobacter pylori infections[J].Ann Intern Med,2003,139(6):463.
- [16]Zullo A,Iemrdi E,Hassan C,et a1.Furazolidone-based therapies for Helicobaaer pylori infcetion.a pooled-data analysis[J].Saudi J Gas—troenterol,2012,18(1):11.