Jones Kathleen R, Cha Jeong-Heon, Merrell D Scott
Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, USA.
Curr Drug ther. 2008 Sep 1;3(3):190-203. doi: 10.2174/157488508785747899.
The ability of clinicians to wage an effective war against many bacterial infections is increasingly being hampered by skyrocketing rates of antibiotic resistance. Indeed, antibiotic resistance is a significant problem for treatment of diseases caused by virtually all known infectious bacteria. The gastric pathogen Helicobacter pylori is no exception to this rule. With more than 50% of the world's population infected, H. pylori exacts a tremendous medical burden and represents an interesting paradigm for cancer development; it is the only bacterium that is currently recognized as a carcinogen. It is now firmly established that H. pylori infection is associated with diseases such as gastritis, peptic and duodenal ulceration and two forms of gastric cancer, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. With such a large percentage of the population infected, increasing rates of antibiotic resistance are particularly vexing for a treatment regime that is already fairly complicated; treatment consists of two antibiotics and a proton pump inhibitor. To date, resistance has been found to all primary and secondary lines of antibiotic treatment as well as to drugs used for rescue therapy.
抗生素耐药率的飙升日益阻碍临床医生有效对抗多种细菌感染的能力。事实上，抗生素耐药性是治疗几乎所有已知传染性细菌引起的疾病的一个重大问题。胃部病原体幽门螺杆菌也不例外。全球超过50%的人口受到感染，幽门螺杆菌带来了巨大的医疗负担，是癌症发展的一个有趣范例；它是目前唯一被公认为致癌物的细菌。现已确定，幽门螺杆菌感染与胃炎、消化性溃疡和十二指肠溃疡以及两种胃癌（胃腺癌和黏膜相关淋巴组织（MALT）淋巴瘤）等疾病有关。由于感染人群比例如此之大，对于本就相当复杂的治疗方案而言，抗生素耐药率的上升尤其令人烦恼；治疗包括两种抗生素和一种质子泵抑制剂。迄今为止，已发现对所有一线和二线抗生素治疗以及用于挽救治疗的药物均产生了耐药性。
