Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy.
J Clin Pathol. 2010 Jul;63(7):648-51. doi: 10.1136/jcp.2010.076844. Epub 2010 May 31.
Clarithromycin (CH) and metronidazole (MZ) are routinely used in Helicobacter pylori treatment regimes. Recently, treatment with these antibiotics has been reported to fail in >30% of patients due to increasing resistance. The common chemosusceptibility methods are cumbersome and take up to 14 days. Chemosusceptibility of H pylori is therefore rarely checked.
To develop a rapid susceptibility test (RST) for H pylori.
Preliminary experiments were performed to find a broth medium able to support the growth of H pylori in 20 h and a reliable detection method to quickly detect the amount of H pylori grown in the media. A mixture of different components was the best broth medium; ELISA was chosen as the detection technique. Performance of the new RST was compared to a gold standard (break point agar dilution method). 200 consecutive patients were tested for H pylori infection and chemosusceptibility to CH and MZ by the gold standard and RST.
111 patients were infected with H pylori. 105 of these were positive by both RST and the gold standard culture method; 75/105 and 68/105 strains were susceptible to CH and MZ, respectively. RST misdiagnosed 2 strains of CH and 10 strains of MZ.
A new simple and rapid chemosusceptibility test for H pylori has been validated, which is simple to perform and reduces the procedure time from 6-14 days to 24 h.
克拉霉素（CH）和甲硝唑（MZ）常用于治疗幽门螺杆菌。由于耐药性的增加，最近报道这些抗生素的治疗成功率超过 30%。常见的化学药敏方法繁琐，需要 14 天时间。因此，很少检查幽门螺杆菌的化学敏感性。
开发一种快速药敏试验（RST）检测幽门螺杆菌。
进行初步实验以找到一种能够在 20 小时内支持幽门螺杆菌生长的肉汤培养基，并找到一种可靠的检测方法来快速检测培养基中生长的幽门螺杆菌数量。不同成分的混合物是最好的肉汤培养基；选择 ELISA 作为检测技术。新的 RST 性能与金标准（琼脂稀释法）进行比较。通过金标准和 RST 对 200 例连续患者进行幽门螺杆菌感染和对 CH 和 MZ 的化学敏感性检测。
111 例患者感染了幽门螺杆菌。105 例患者 RST 和金标准培养法均为阳性；75/105 和 68/105 株分别对 CH 和 MZ 敏感。RST 误诊了 2 株 CH 和 10 株 MZ。
已验证一种新的简单快速的幽门螺杆菌化学药敏试验，该方法简单易行，将检测时间从 6-14 天缩短至 24 小时。
