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马来西亚幽门螺杆菌对甲硝唑的耐药率很高,但对克拉霉素、左氧氟沙星和其他抗生素的耐药率为零或很低。

High Helicobacter pylori resistance to metronidazole but zero or low resistance to clarithromycin, levofloxacin, and other antibiotics in Malaysia.

机构信息

Division of Gastroenterology and Hepatology, University of Malaya, Kuala Lumpur, Malaysia.

出版信息

Helicobacter. 2011 Jun;16(3):241-5. doi: 10.1111/j.1523-5378.2011.00841.x.


DOI:10.1111/j.1523-5378.2011.00841.x
PMID:21585611
Abstract

OBJECTIVE: Bacterial resistance to antibiotics is the single most important determinant of treatment success. The objective of this study was to determine the prevalence of Helicobacter pylori resistance to clarithromycin, amoxicillin, metronidazole, tetracycline, levofloxacin, rifabutin, and furazolidone in our local bacterial strains. METHODS: Samples from consecutive ninety patients were obtained for culture and sensitivity testing. Resistance to individual antibiotics were tested using the E-test and MIC(90) read from the strips. Resistance to rifampicin and nitrofurantoin were used as a surrogate for rifabutin and furazolidine. RESULTS: There was a high prevalence of resistance to metronidazole 68/90 (75.5%). No male (34/45 (75.5%) versus female (35/45 (77.7%) difference in frequency of metronidazole resistance was noted (p = 1.000). There was zero resistance (0) to clarithromycin, levofloxacin, amoxicillin, and nitrofurantoin/furazolidone. Resistance to rifampicin/rifabutin was for breakpoints of 1 and 4 μg/mL of 14.4 and 2.2% respectively. CONCLUSIONS: Although there was high bacterial resistance to metronidazole, the absence of resistance particularly to the key antibiotics used in H. pylori eradication therapy: clarithromycin and levofloxacin is reassuring to note. Continued monitoring of antibiotic resistance should be carried out.

摘要

目的:细菌对抗生素的耐药性是治疗成功的唯一最重要的决定因素。本研究的目的是确定本地区幽门螺杆菌对克拉霉素、阿莫西林、甲硝唑、四环素、左氧氟沙星、利福布汀和呋喃唑酮的耐药率。

方法:连续 90 例患者的标本用于培养和药敏试验。使用 E 试验和条带的 MIC(90)测试个体抗生素的耐药性。利福平耐药和呋喃妥因耐药被用作利福布汀和呋喃唑酮的替代物。

结果:甲硝唑耐药率高,共 68/90(75.5%)。甲硝唑耐药的男性(34/45(75.5%)与女性(35/45(77.7%)之间无差异(p=1.000)。克拉霉素、左氧氟沙星、阿莫西林和硝基呋喃/呋喃唑酮均无耐药性(0)。利福平/利福布汀的耐药率分别为 1 和 4μg/ml 的 14.4%和 2.2%。

结论:尽管甲硝唑耐药率较高,但特别对幽门螺杆菌根除治疗中使用的关键抗生素(克拉霉素和左氧氟沙星)无耐药性,这令人欣慰。应继续监测抗生素耐药性。

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