Rimbara E, Noguchi N, Tanabe M, Kawai T, Matsumoto Y, Sasatsu M
Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Science, Hachioji, Tokyo, Japan.
Clin Microbiol Infect. 2005 Apr;11(4):307-11. doi: 10.1111/j.1469-0691.2005.01099.x.
The aim of this study was to determine the susceptibilities to clarithromycin, amoxycillin and metronidazole of Helicobacter pylori isolates from the antrum and corpus of Japanese patients examined during the period 1995-2001. There was an increase, from 6.2% in 1995 to 22.1% in 2000-2001, in the proportion of patients infected with clarithromycin-resistant H. pylori. Of patients infected with clarithromycin-resistant H. pylori, 39.1% were infected with both clarithromycin-susceptible and -resistant H. pylori. Furthermore, the MIC90 of clarithromycin for H. pylori rose from < 1 mg/L in 1995-1998 to 8 mg/L in 1999. In contrast, the MIC90s of amoxycillin and metronidazole were < or = 0.125 and 4 mg/L, respectively, throughout the study period. The results showed that, while most H. pylori isolates were susceptible to amoxycillin and metronidazole, resistance to clarithromycin among H. pylori isolates increased markedly in Japan during 1995-2001. The results also indicated a need to test the susceptibility of H. pylori isolates from more than two samples obtained from two different sites in the stomach of a single patient in order to diagnose the presence of clarithromycin-resistant H. pylori correctly.
本研究的目的是确定1995年至2001年期间接受检查的日本患者胃窦和胃体中分离出的幽门螺杆菌对克拉霉素、阿莫西林和甲硝唑的敏感性。对克拉霉素耐药的幽门螺杆菌感染患者比例从1995年的6.2%上升至2000 - 2001年的22.1%。在对克拉霉素耐药的幽门螺杆菌感染患者中，39.1%同时感染了对克拉霉素敏感和耐药的幽门螺杆菌。此外，幽门螺杆菌对克拉霉素的MIC90从1995 - 1998年的<1mg/L升至1999年的8mg/L。相比之下，在整个研究期间，阿莫西林和甲硝唑的MIC90分别≤0.125mg/L和4mg/L。结果表明，虽然大多数幽门螺杆菌分离株对阿莫西林和甲硝唑敏感，但在1995 - 2001年期间，日本幽门螺杆菌分离株对克拉霉素的耐药性显著增加。结果还表明，为了正确诊断对克拉霉素耐药的幽门螺杆菌的存在，需要对来自单个患者胃中两个不同部位的两个以上样本分离出的幽门螺杆菌进行药敏试验。
