Section of Gastroenterology, Department of Medical Sciences, University of Foggia, Ospedali Riuniti,Viale L. Pinto 71100, Foggia, Italy.
J Gastrointestin Liver Dis. 2011 Sep;20(3):235-9.
Primary clarithromycin resistance markedly reduces Helicobacter pylori eradication rate following standard therapies. Prevalence of primary clarithromycin resistance in H. pylori is increasing, and three point mutations are mainly involved. AIM. To assess both the prevalence of primary clarithromycin resistance in Italy, and the distribution of the involved point mutations.
Primary clarithromycin resistance was assessed by TaqMan real-time polymerase chain reaction on antral biopsies of 253 consecutive, H. pylori infected patients enrolled in 13 Italian centres between January and September 2010.
Primary clarithromycin resistance was detected in 25 (9.9%) patients, with prevalence values widely ranging from 0 to 25%. Clarithromycin resistance rate was higher in female as compared to male patients (13.4% vs. 5.3%, p=0.03), and it tended to be higher in non-ulcer dyspepsia than in peptic ulcer patients (10.6% vs. 6.9%, p=0.5), female patients with non-ulcer dyspepsia showing the highest value (15.4%). The A2143G point mutation was detected in 13 (52.0%) patients, the A2142G in 9 (34.6%), whilst a double point mutation (A2143G plus A2142G) in 3 (11.6%) cases.
Primary clarithromycin resistance is highly variable in different Italian geographic areas. High resistance rates were observed in female and in dyspeptic patients. Among the three point mutations of clarithromycin resistance, the A2143G remains the most frequently observed.
主要克拉霉素耐药性明显降低幽门螺杆菌根除率以下的标准疗法。原发性克拉霉素耐药幽门螺杆菌的患病率正在增加，主要涉及三个点突变。目的。评估意大利原发性克拉霉素耐药的流行率，并参与点突变的分布。
采用 TaqMan 实时聚合酶链反应对 253 例连续的、幽门螺杆菌感染患者的胃窦活检标本进行检测，这些患者于 2010 年 1 月至 9 月在意大利 13 个中心注册。
25 例（9.9%）患者检测到原发性克拉霉素耐药，耐药率从 0 到 25%不等。与男性患者相比，女性患者的克拉霉素耐药率更高（13.4%比 5.3%，p=0.03），非溃疡性消化不良患者的耐药率高于消化性溃疡患者（10.6%比 6.9%，p=0.5），非溃疡性消化不良的女性患者耐药率最高（15.4%）。检测到 A2143G 点突变 13 例（52.0%），A2142G 9 例（34.6%），双点突变（A2143G 加 A2142G）3 例（11.6%）。
原发性克拉霉素耐药性在不同的意大利地理区域差异很大。在女性和消化不良患者中观察到高耐药率。在克拉霉素耐药的三个点突变中，A2143G 仍然是最常见的。
