Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Saudi J Gastroenterol. 2011 Jul-Aug;17(4):261-4. doi: 10.4103/1319-3767.82581.
BACKGROUND/AIM: Helicobacter pylori is an important pathogen for gastroduodenal diseases. Infection with H. pylori can be limited by regimens of multiple antimicrobial agents. However, antibiotic resistance is a leading cause of treatment failure. The aim of this study has been to determine the resistance patterns of H. pylori strains isolated from gastric biopsies of patients with dyspepsia by agar dilution method, in Tehran, Iran.
H. pylori isolates from patients with gastrointestinal diseases were evaluated for susceptibility testing by agar dilution method. Susceptibility testing was performed to commonly used antibiotics including clarithromycin, tetracycline, amoxicillin, metronidazole and ciprofloxacin.
Among 92 patients with dyspepsia, H. pylori strains were isolated from 42 patients. Seventeen (40.5%) of the isolates were resistant to metronidazole (MICs ≥ 8 μg/l), whereas one isolate (2.4%) was resistant to amoxicillin (MICs ≤ 0. 5 μg/ml) and ciprofloxacin (MICs ≤ 1μg/ml). The resistance rates to other antibiotics in H. pylori isolates are recorded as follows: clarithromycin 6 (14.3 %), tetracycline 2 (4.8%). In 5 of 42 resistant cases, combined resistance was found.
These data suggest that metronidazole should be used among Iranian patients in first-line therapy with caution, and ciprofloxacin in association with amoxicillin and a proton pump inhibitor is more recommended.
背景/目的：幽门螺杆菌是引起胃十二指肠疾病的重要病原体。感染幽门螺杆菌可以通过多种抗生素方案来限制。然而，抗生素耐药性是治疗失败的主要原因。本研究的目的是通过琼脂稀释法确定来自伊朗德黑兰消化不良患者胃活检的幽门螺杆菌菌株的耐药模式。
通过琼脂稀释法评估胃肠道疾病患者的幽门螺杆菌分离株进行药敏试验。对包括克拉霉素、四环素、阿莫西林、甲硝唑和环丙沙星在内的常用抗生素进行了药敏试验。
在 92 名消化不良患者中，42 名患者分离出幽门螺杆菌菌株。17 株（40.5%）分离株对甲硝唑（MICs≥8μg/l）耐药，1 株（2.4%）对阿莫西林（MICs≤0.5μg/ml）和环丙沙星（MICs≤1μg/ml）耐药。幽门螺杆菌分离株对其他抗生素的耐药率如下：克拉霉素 6 株（14.3%），四环素 2 株（4.8%）。在 42 例耐药病例中，有 5 例发现联合耐药。
这些数据表明，在伊朗患者中，甲硝唑应谨慎用于一线治疗，而环丙沙星联合阿莫西林和质子泵抑制剂则更推荐使用。
