Lee M G, Arthurs M, Smikle M F, Dowe G, Levy V, Barton E N
Department of Medicine, The University of the West Indies, Kingston 7, Jamaica, West Indies.
West Indian Med J. 2004 Dec;53(6):374-7.
Helicobacter pylori infection is one of the commonest chronic infections worldwide. Eradication regimes usually contain two antibiotics, however resistance is increasing and this decreases treatment success. This study reports on the sensitivity and resistance of H pylori to several antibiotics in patients undergoing upper gastrointestinal endoscopy in Jamaica. The rapid urease test (CLO) was positive in 128 (38%) of 336 patients. Fifty patients (39%; 50/128) with positive CLO tests had positive cultures for H pylori. Two-thirds (32/48) of islolates were sensitive to metronidazole and one-third (16/48) were resistant. Ninety-seven per cent of isolates (31/32) were sensitive to erythromycin. The sensitivity for clarithromycin was 92% (11/12) with one isolate (8%) resistant. All strains of H pylori (48/48) were sensitive to ampicillin and amoxicillin - clavulanate. Metronidazole resistance is present in one-third of H pylori isolates and resistance to macrolides is relatively low in Jamaican patients. It is important to monitor antibiotic resistance in order to provide clinicians with data on the most appropriate and cost effective eradication regimes for H pylori.
幽门螺杆菌感染是全球最常见的慢性感染之一。根除方案通常包含两种抗生素，然而耐药性正在增加，这降低了治疗成功率。本研究报告了牙买加接受上消化道内镜检查患者中幽门螺杆菌对几种抗生素的敏感性和耐药性。336例患者中128例（38%）快速尿素酶试验（CLO）呈阳性。50例CLO试验阳性患者（39%；50/128）幽门螺杆菌培养阳性。三分之二（32/48）的分离株对甲硝唑敏感，三分之一（16/48）耐药。97%的分离株（31/32）对红霉素敏感。克拉霉素的敏感性为92%（11/12），1株（8%）耐药。所有幽门螺杆菌菌株（48/48）对氨苄西林和阿莫西林-克拉维酸盐敏感。三分之一的幽门螺杆菌分离株存在甲硝唑耐药，牙买加患者对大环内酯类的耐药性相对较低。监测抗生素耐药性很重要，以便为临床医生提供关于幽门螺杆菌最适宜和最具成本效益的根除方案的数据。
