Department of Biochemistry and Microbiology, University of Fort Hare, Alice, E Cape.
S Afr Med J. 2010 Jan;100(1):49-52.
Helicobacter pylori-associated infection is common in South Africa, as in other developing countries. Antibiotic resistance is recognised as a major cause of treatment failure. We studied the susceptibility and resistance patterns of H. pylori to guide empiric treatment and prevent the emergence of resistance.
Two hundred H. pylori strains obtained from gastric biopsies of patients presenting with gastric-related morbidities attending Livingstone Hospital, Port Elizabeth, were evaluated for their susceptibility to seven antibiotics - metronidazole, clarithromycin, tetracycline, amoxicillin, gentamicin, ciprofloxacin and erythromycin. H. pylori was isolated following standard microbiology procedures, and susceptibility determined using the Kirby-Bauer disc diffusion and agar dilution methods. Comparisons of antimicrobial resistance rates with sex of the patients were determined using the chi-square test; a p-value of <0.05 was considered significant.
Marked susceptibility was observed for ciprofloxacin (100%) and amoxicillin (97.5%), and good activity for clarithromycin (80%) and gentamicin (72.5%). However, marked resistance (95.5%) was observed for metronidazole. The minimal inhibitory concentration (MIC) ranged from 0.0625 microg/ml to 8 microg/ml. The lowest MIC, with a range of 0.0625 - 1 microg/ml, was recorded for ciprofloxacin, while the highest (5 - 8 microg/ml) was noted for gentamicin.
Multidrug resistance was commonly encountered - a finding of clinical significance that calls for continuous surveillance of antibiograms to guide empiric treatment. We advocate the inclusion of ciprofloxacin in the treatment regimen of H. pylori infection in our study environment.
幽门螺杆菌相关感染在南非很常见，与其他发展中国家一样。抗生素耐药性被认为是治疗失败的主要原因。我们研究了幽门螺杆菌对七种抗生素的敏感性和耐药模式，以指导经验性治疗并预防耐药性的出现。
从伊丽莎白港利文斯顿医院因胃部相关疾病就诊的患者的胃活检中获得了 200 株幽门螺杆菌菌株，评估它们对七种抗生素的敏感性 - 甲硝唑、克拉霉素、四环素、阿莫西林、庆大霉素、环丙沙星和红霉素。按照标准微生物学程序分离幽门螺杆菌，并使用 Kirby-Bauer 圆盘扩散和琼脂稀释法确定敏感性。使用卡方检验比较患者性别与抗生素耐药率之间的差异；p 值<0.05 被认为具有统计学意义。
观察到对环丙沙星（100%）和阿莫西林（97.5%）具有显著的敏感性，对克拉霉素（80%）和庆大霉素（72.5%）具有良好的活性。然而，对甲硝唑的耐药性显著（95.5%）。最小抑菌浓度（MIC）范围为 0.0625 µg/ml 至 8 µg/ml。最低 MIC（范围为 0.0625-1 µg/ml）记录为环丙沙星，而最高 MIC（5-8 µg/ml）记录为庆大霉素。
普遍存在多种药物耐药性 - 这一发现具有临床意义，需要不断监测抗生素药敏谱以指导经验性治疗。我们主张在我们的研究环境中，将环丙沙星纳入幽门螺杆菌感染的治疗方案中。
