Department of Internal Medicine, Gachon Graduate School of Medicine, Gil Medical Center, Incheon, Korea.
J Gastroenterol Hepatol. 2012 Mar;27(3):493-7. doi: 10.1111/j.1440-1746.2011.06874.x.
New regimens, including those with new fluoroquinolones, have been developed to overcome the antibiotic resistance of Helicobacter pylori. We aimed to assess the antibiotic resistance rates, as well as the molecular mechanisms of fluoroquinolone resistance, of the clinical isolates obtained in Korea.
The minimal inhibitory concentration (MIC) values of ciprofloxacin, amoxicillin, clarithromycin, metronidazole and tetracycline were determined by the agar dilution method for 185 treatment-naïve Helicobacter pylori isolates. The resistant strains were evaluated for the presence of point mutations in the quinolone resistance-determining region (QRDR) of the gyrA and gyrB genes by direct nucleotide sequencing.
Twenty-nine (29/185, 15.7%) of the strains were found to be resistant to ciprofloxacin. The resistance rates to amoxicillin, clarithromycin, metronidazole and tetracycline were 2.2% (four of 185), 10.8% (20 of 185), 30.3% (56 of 185) and 0.5% (one of 185), respectively. The most common mutations in the H. pylori gyrA gene were found at codons corresponding to Asp87 (16/29, 55.2%) and Asn91 (10/29, 34.5%).
Primary H. pylori resistance to ciprofloxacin occurred at a high frequency. The fluoroquinolone resistance is most likely mediated through amino acid point mutation in the gyrA gene at Asn87 and Asp91.
为了克服幽门螺杆菌的抗生素耐药性，已经开发了新的方案，包括使用新型氟喹诺酮类药物。我们旨在评估韩国临床分离株的抗生素耐药率以及氟喹诺酮类耐药的分子机制。
采用琼脂稀释法测定 185 株未经治疗的幽门螺杆菌分离株对环丙沙星、阿莫西林、克拉霉素、甲硝唑和四环素的最小抑菌浓度（MIC）值。通过直接核苷酸测序评估耐药株喹诺酮耐药决定区（QRDR）中 gyrA 和 gyrB 基因的点突变情况。
29 株（185 株的 29/185，15.7%）被发现对环丙沙星耐药。对阿莫西林、克拉霉素、甲硝唑和四环素的耐药率分别为 2.2%（185 株中的 4 株）、10.8%（20 株）、30.3%（56 株）和 0.5%（185 株中的 1 株）。幽门螺杆菌 gyrA 基因最常见的突变发生在对应于 Asp87（16/29，55.2%）和 Asn91（10/29，34.5%）的密码子。
幽门螺杆菌对环丙沙星的原发性耐药率很高。氟喹诺酮类耐药很可能是通过 gyrA 基因中 Asp87 和 Asn91 氨基酸的点突变介导的。
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