Department of Bacteriology Tehran, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran.
Helicobacter. 2010 Dec;15(6):505-9. doi: 10.1111/j.1523-5378.2010.00795.x.
The aim of this study was to investigate the prevalence of resistances in Helicobacter pylori against commonly used antibiotics including metronidazole, clarithromycin, amoxicillin, and tetracycline in Iranian patients.
H. pylori isolates were collected from gastric biopsies from patients referred for upper gastrointestinal endoscopy at Tooba Medical Center, Sari, Iran, from 2007 to 2010. None of them had been using antibiotics for at least 8 months. H. pylori was identified based on morphological shape and positive biochemical tests for catalase, oxidase, and urease activity. Antibiotic resistance for metronidazole, clarithromycin, amoxicillin, and tetracycline was investigated by using epsilometer test. Resistance was defined by minimal inhibitory concentration (MIC) > 0.5 mg/L for amoxicillin (AMX), >4 mg/L for tetracycline (TET), >8 mg/L for metronidazole (MTZ), and >1 mg/L for clarithromycin (CLR).
Strains were collected from 132 patients, mean age 45.8 years, 52 (39%) were women. Patients had diverse diagnoses: gastritis 42 (31.8%), duodenal ulcer 45 (34%), gastric cancer 15 (11.3%), or gastric ulcer 30 (22.7%). The prevalences of resistance of H. pylori strains isolated from the patients were 73.4% for metronidazole, 30% for clarithromycin, 6.8% for amoxicillin, and 9% for tetracycline. Twenty-eight (21.2%) were double resistant to MTZ-CLR, 16 (12.1%) showed triple resistance to MTZ-CLR-AMX, and 8 (6%) were resistant to all four tested antibiotics (MTZ-CLR-AMX-TET). No associations were detected between multiple resistant strains and clinical manifestations (p > .05).
The prevalence of H. pylori antibiotic resistance to metronidazole and clarithromycin was high in Iran consistent with the reported low success rates for H. pylori treatment in this country.
本研究旨在调查伊朗患者中幽门螺杆菌对常用抗生素（包括甲硝唑、克拉霉素、阿莫西林和四环素）的耐药率。
2007 年至 2010 年，从伊朗萨里 Tooba 医疗中心因上消化道内镜检查而就诊的患者的胃活检中采集幽门螺杆菌分离株。他们中没有人在过去 8 个月内使用过抗生素。基于形态学形状和过氧化氢酶、氧化酶和脲酶活性的阳性生化试验，鉴定幽门螺杆菌。使用 Epsilometer 试验检测甲硝唑、克拉霉素、阿莫西林和四环素的抗生素耐药性。阿莫西林（AMX）的最小抑菌浓度（MIC）>0.5 毫克/升、四环素（TET）>4 毫克/升、甲硝唑（MTZ）>8 毫克/升和克拉霉素（CLR）>1 毫克/升定义为耐药。
共采集了 132 名患者的菌株，平均年龄为 45.8 岁，52 名（39%）为女性。患者有多种诊断：胃炎 42 例（31.8%）、十二指肠溃疡 45 例（34%）、胃癌 15 例（11.3%）和胃溃疡 30 例（22.7%）。从患者中分离的幽门螺杆菌菌株的耐药率分别为甲硝唑 73.4%、克拉霉素 30%、阿莫西林 6.8%和四环素 9%。28 株（21.2%）对 MTZ-CLR 呈双重耐药，16 株（12.1%）对 MTZ-CLR-AMX 呈三重耐药，8 株（6%）对四种检测抗生素（MTZ-CLR-AMX-TET）均耐药。多耐药菌株与临床表现之间无相关性（p>.05）。
与该国报道的幽门螺杆菌治疗成功率低一致，伊朗幽门螺杆菌对甲硝唑和克拉霉素的耐药率较高。
