Department of Gastroenterology, Peking University First Hospital, Beijing, China.
Helicobacter. 2010 Oct;15(5):460-6. doi: 10.1111/j.1523-5378.2010.00788.x.
To evaluate Helicobacter pylori antibiotics resistance evolution from 2000 to 2009 to amoxicillin, clarithromycin, metronidazole, tetracycline, levofloxacin and moxifloxacin in Beijing, China.
A total of 374 H. pylori strains isolated from 374 subjects who had undergone upper gastrointestinal endoscopy from 2000 to 2009 were collected and examined by E-test method for antibiotics susceptibility.
The average antibiotics resistance rates were 0.3% (amoxicillin), 37.2% (clarithromycin), 63.9% (metronidazole), 1.2% (tetracycline), 50.3% (levofloxacin) and 61.9% (moxifloxacin). Overall resistance to clarithromycin, metronidazole, and fluoroquinolone increased annually (from 14.8 to 65.4%, 38.9 to 78.8%, and 27.1 to 63.5%, in 2000 or 2006-2007 to 2009, respectively). The secondary resistance rates were much higher than primary rates to these antibiotics, which also increased annually in recent 10 years.
The trend of clarithromycin, metronidazole, and fluoroquinolone resistance of H. pylori increased over time and the resistance to amoxicillin and tetracycline was infrequent and stable in Beijing. Clarithromycin, metronidazole, and fluoroquinolone should be used with caution for H. pylori eradication treatment.
评估中国北京地区 2000 年至 2009 年期间幽门螺杆菌对阿莫西林、克拉霉素、甲硝唑、四环素、左氧氟沙星和莫西沙星的抗生素耐药性演变。
收集 2000 年至 2009 年间 374 例接受上消化道内镜检查的患者的 374 株幽门螺杆菌菌株，采用 E 试验法检测抗生素敏感性。
抗生素耐药率平均分别为 0.3%（阿莫西林）、37.2%（克拉霉素）、63.9%（甲硝唑）、1.2%（四环素）、50.3%（左氧氟沙星）和 61.9%（莫西沙星）。克拉霉素、甲硝唑和氟喹诺酮类药物的总体耐药率逐年增加（2000 年或 2006-2007 年至 2009 年分别从 14.8%升至 65.4%、38.9%升至 78.8%和 27.1%升至 63.5%）。这些抗生素的继发耐药率明显高于原发耐药率，且在过去 10 年中也呈逐年上升趋势。
随着时间的推移，幽门螺杆菌对克拉霉素、甲硝唑和氟喹诺酮类药物的耐药趋势不断增加，而对阿莫西林和四环素的耐药性则较为少见且稳定。在治疗幽门螺杆菌感染时应谨慎使用克拉霉素、甲硝唑和氟喹诺酮类药物。
