用于从胃活检组织中分离幽门螺杆菌的培养基与抗生素添加剂的比较

Chomvarin Chariya, Kulsantiwong Panthong, Chantarasuk Yingrit, Chantrakooptungool Suriwan, Kanjanahareutai Suwattana

Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.

Southeast Asian J Trop Med Public Health. 2006 Nov;37(6):1163-9.

Our objective was to improve the media and the antibiotic supplements in order to increase the detection rate of Helicobacter pylori from gastric biopsy specimens. For the primary isolation of H. pylori taken from gastric biopsies, we compared the efficacy of two media: Columbia blood agar (CBA, Difco); brain heart infusion agar (BHIA, Difco); and two antibiotic supplement sets--a commercial antibiotic supplement (SR147, Oxoid) and an in-house antibiotic supplement (IHS). Gastric biopsies obtained from 210 patients were diagnosed by culture, rapid urease test (RUT) and histology. The true positive criteria were defined as a culture or both urease and histology tests being positive. The H. pylori infection rate was 44.3% (93/ 210). To compare the two media, a total of 106 gastric biopsies were plated on CBA or BHIA with 7% human blood, containing the antibiotic supplement SR147 and incubated under microaerophilic conditions. Of the 106 samples, 48 (45.3%) case of H. pylori infection, compared to the true positive criteria. The isolation rate using a combination of the two media was 83% (40/48). Of the 40 samples, 36 (90%) and 35 (87.5%) were positive on CBA and BHIA, respectively. To compare the two antibiotic supplement sets, a total of 104 gastric biopsies were plated on CBA, containing the commercial antibiotic supplement SR147 (5 mg/l trimethoprim, 10 mg/l vancomycin, 5 mg/l amphotericin B and 5 mg/l cefsulodin) or containing IHS (5 mg/l trimethoprim, 10 mg/l vancomycin, 2 mg/l amphotericin B and 2,500 U/l polymyxin B). Of the 104 samples, 45 (43.2%) case of H. pylori infection were found compared to the true positive criteria. The isolation rate using a combination of the two selective supplement sets was 82% (37/45). Of the 37 samples, 35 (95%) and 34 (92%) were positive with SR147 and IHS, respectively. Our study indicates that the combination of the two media and two antibiotic supplements is useful for maximum recovery of H. pylori isolated from gastric biopsies. CBA, and the commercial antibiotic supplement SR147 provided higher detection rates for H. pylori than BHIA, and IHS but the differences were not statistically significant.

我们的目标是改进培养基和抗生素添加剂，以提高从胃活检标本中检测幽门螺杆菌的比率。对于取自胃活检组织的幽门螺杆菌的初次分离，我们比较了两种培养基的效果：哥伦比亚血琼脂（CBA，Difco公司）；脑心浸液琼脂（BHIA，Difco公司）；以及两种抗生素添加剂组合——一种商业抗生素添加剂（SR147，Oxoid公司）和一种自制抗生素添加剂（IHS）。通过培养、快速尿素酶试验（RUT）和组织学检查对210例患者的胃活检组织进行诊断。真阳性标准定义为培养阳性或尿素酶试验和组织学检查均为阳性。幽门螺杆菌感染率为44.3%（93/210）。为比较这两种培养基，将总共106份胃活检组织接种在含有7%人血、抗生素添加剂SR147的CBA或BHIA上，并在微需氧条件下培养。在这106份样本中，与真阳性标准相比，有48例（45.3%）幽门螺杆菌感染。两种培养基联合使用的分离率为83%（40/48）。在这40份样本中，CBA和BHIA上分别有36例（90%）和35例（87.5%）呈阳性。为比较这两种抗生素添加剂组合，将总共104份胃活检组织接种在含有商业抗生素添加剂SR147（5mg/L甲氧苄啶、10mg/L万古霉素、5mg/L两性霉素B和5mg/L头孢磺啶）或含有IHS（5mg/L甲氧苄啶、10mg/L万古霉素、2mg/L两性霉素B和2500U/L多粘菌素B）的CBA上。在这104份样本中，与真阳性标准相比，发现45例（43.2%）幽门螺杆菌感染。两种选择性添加剂组合联合使用的分离率为82%（37/45）。在这37份样本中，SR147和IHS分别有35例（95%）和34例（92%）呈阳性。我们的研究表明，两种培养基和两种抗生素添加剂的组合有助于从胃活检组织中最大程度地分离出幽门螺杆菌。CBA和商业抗生素添加剂SR147对幽门螺杆菌的检测率高于BHIA和IHS，但差异无统计学意义。