Boyanova L, Mentis A, Gubina M, Rozynek E, Gosciniak G, Kalenic S, Göral V, Kupcinskas L, Kantarçeken B, Aydin A, Archimandritis A, Dzierzanowska D, Vcev A, Ivanova K, Marina M, Mitov I, Petrov P, Ozden A, Popova M
Department of Microbiology, Medical University of Sofia, Sofia, Bulgaria.
Clin Microbiol Infect. 2002 Jul;8(7):388-96. doi: 10.1046/j.1469-0691.2002.00435.x.
To evaluate the primary, secondary and combined resistance to five antimicrobial agents of 2340 Helicobacter pylori isolates from 19 centers in 10 countries in eastern Europe.
Data were available for centers in Bulgaria, Croatia, the Czech Republic, Estonia, Greece, Lithuania, Poland, Russia, Slovenia and Turkey. Susceptibility was tested by agar dilution (seven countries), E test (five countries) and disk diffusion (three countries) methods. Resistance breakpoints (mg/L) were: metronidazole 8, clarithromycin 1, amoxicillin 0.5, tetracycline 4, and ciprofloxacin 1 or 4 in most centers. Primary and post-treatment resistance was assessed in 2003 and 337 isolates respectively. Results for 282 children and 201 adults were compared.
Primary resistance rates since 1998 were: metronidazole 37.9%, clarithromycin 9.5%, amoxicillin 0.9%, tetracycline 1.9%, ciprofloxacin 3.9%, and both metronidazole and clarithromycin 6.1%. Isolates from centers in Slovenia and Lithuania exhibited low resistance rates. Since 1998, amoxicillin resistance has been detected in the southeastern region. From 1996, metronidazole resistance increased significantly from 30.5% to 36.4%, while clarithromycin resistance increased slightly from 8.9% to 10.6%. In centers in Greece, Poland, and Bulgaria, the mean metronidazole resistance was slightly higher in adults than in children (39% versus 31.2%, P > 0.05); this trend was not found for clarithromycin or amoxicillin (P > 0.20). Post-treatment resistance rates exhibited wide variations.
In eastern Europe, primary H. pylori resistance to metronidazole is considerable, and that to clarithromycin is similar to or slightly higher than that in western Europe. Resistance to amoxicillin, ciprofloxacin and tetracycline was detected in several centers. Primary and post-treatment resistance rates vary greatly between centers.
评估来自东欧10个国家19个中心的2340株幽门螺杆菌对五种抗菌药物的原发、继发及联合耐药情况。
数据来自保加利亚、克罗地亚、捷克共和国、爱沙尼亚、希腊、立陶宛、波兰、俄罗斯、斯洛文尼亚和土耳其的中心。采用琼脂稀释法（7个国家）、E试验法（5个国家）和纸片扩散法（3个国家）检测药敏。大多数中心的耐药断点（mg/L）为：甲硝唑8、克拉霉素1、阿莫西林0.5、四环素4、环丙沙星1或4。分别于2003年评估原发耐药情况，对337株菌株评估治疗后耐药情况。比较了282名儿童和201名成人的结果。
自1998年以来的原发耐药率为：甲硝唑37.9%、克拉霉素9.5%、阿莫西林0.9%、四环素1.9%、环丙沙星3.9%，甲硝唑和克拉霉素均耐药为6.1%。斯洛文尼亚和立陶宛中心的分离株耐药率较低。自1998年以来，东南部地区检测到阿莫西林耐药。自1996年以来，甲硝唑耐药率从30.5%显著升至36.4%，而克拉霉素耐药率从8.9%略有升至10.6%。在希腊、波兰和保加利亚的中心，成人甲硝唑平均耐药率略高于儿童（39%对31.2%，P>0.05）；克拉霉素或阿莫西林未发现此趋势（P>0.20）。治疗后耐药率差异很大。
在东欧，幽门螺杆菌对甲硝唑的原发耐药情况较为严重，对克拉霉素的耐药情况与西欧相似或略高于西欧。在几个中心检测到对阿莫西林、环丙沙星和四环素的耐药。不同中心的原发和治疗后耐药率差异很大。
