Bacteriology Unit, Institute for Medical Research, Jalan Pahang, 50588, Kuala Lumpur, Malaysia.
Helicobacter. 2011 Feb;16(1):47-51. doi: 10.1111/j.1523-5378.2010.00816.x.
The prevalence of antibiotic resistance varies in geographic areas. The information on the antibiotic susceptibility patterns of Helicobacter pylori (H. pylori) in our local setting is therefore relevant as a guide for the treatment options.
This study was conducted to determine the primary resistance rates among H. pylori isolated from Malaysian patients.
Biopsy samples were obtained from the stomach antrum and corpus of 777 patients from September 2004 until 2007. H. pylori isolated from these patients were then subjected to minimum inhibitory concentration (MICs) determination using E-test method, against metronidazole, clarithromycin, levofloxacin, ciprofloxacin, amoxicillin, and tetracycline.
From 777 patients, 119 were positive for H. pylori where a total of 187 strains were isolated. The resistance rates were noted to be 37.4% (metronidazole), 2.1% (clarithromycin), 1% (levofloxacin and ciprofloxacin), and 0% (amoxicillin and tetracycline). Different resistance profiles were observed among isolates from the antrum and corpus of 13 patients. Resistance to one type of antibiotic was observed in 36.4% of the strains where mono-resistance to metronidazole was the most common. Resistance to ≥2 antibiotics was noted in 3.3% of isolates. High metronidazole MICs of ≥256 μg/mL were observed among the resistant strains.
The resistance rates of the antibiotics used in primary treatment of H. pylori infections in Malaysia are low, and multi-antibiotic-resistant strains are uncommon. Infections with mixed populations of metronidazole-sensitive and -resistant strains were also observed. However, the high metronidazole MIC values seen among the metronidazole-resistant strains are a cause for concern.
抗生素耐药性在地理区域上存在差异。因此，了解我们当地幽门螺杆菌（H. pylori）的抗生素敏感性模式的信息对于治疗方案的选择具有重要意义。
本研究旨在确定从马来西亚患者中分离的 H. pylori 的主要耐药率。
2004 年 9 月至 2007 年，从 777 名患者的胃窦和胃体采集活检样本。然后，采用 E 试验法对这些患者分离的 H. pylori 进行最低抑菌浓度（MIC）测定，检测药物包括甲硝唑、克拉霉素、左氧氟沙星、环丙沙星、阿莫西林和四环素。
在 777 名患者中，有 119 名患者 H. pylori 阳性，共分离出 187 株菌株。耐药率分别为 37.4%（甲硝唑）、2.1%（克拉霉素）、1%（左氧氟沙星和环丙沙星）和 0%（阿莫西林和四环素）。从 13 名患者的胃窦和胃体分离出的菌株中观察到不同的耐药谱。36.4%的菌株对一种抗生素耐药，其中甲硝唑单耐药最常见。3.3%的分离株对≥2 种抗生素耐药。耐药菌株的甲硝唑 MIC 值≥256μg/ml 较高。
在马来西亚，用于 H. pylori 感染初始治疗的抗生素耐药率较低，且多药耐药株并不常见。还观察到混合敏感和耐药菌株的感染。然而，甲硝唑耐药株中观察到的甲硝唑 MIC 值较高令人担忧。
