Ilie Mădălina, Popa Marcela, Chifiriuc Mariana Carmen, Baltac Alina, Constantinescu Gabriel, Tănăsescu Coman
Emergency Hospital, Gastroenterology, Bucharest, Romania.
Roum Arch Microbiol Immunol. 2011 Apr-Jun;70(2):60-4.
Helicobacter pylori is one of the most common among the numerous bacterial species of the stomach. It is classified as a class 1 carcinogen because of its causal relationship to gastric adenocarcinoma. The epidemiology of H. pylori infection is characterized by a marked difference between developing and developed countries. Treatment of H. pylori still remains a challenge due to the high rate of antibiotic resistance. The aim of this study was to investigate the susceptibility of H. pylori strains isolated from gastric biopsies to different antibiotics currently used in the H. pylori infection treatment schemes.
Upper gastrointestinal GI endoscopy was performed, followed by the rapid urease test on gastric biopsies. The positive samples were cultivated on specific media under microaerophilic conditions and the antibiotic susceptibility assay was performed on the isolated strains.
A positivity rate of 70% was obtained for cultures performed from the biopsy samples positive for the urease test. The resistance rates for the antibiotics used in the classic triple therapy proved to be high, i.e. 92.8% for metronidazole, 50% for amoxicillin and 32% for clarithromycin. The isolated strains proved to be sensitive to ciprofloxacin and levofloxacin.
The role of gastric microbiota and its contribution to the H. pylori associated pathology need to be established. The problem of antibiotic treatment failure in case of resistant H. pylori strains can be surpassed by routine culture and antibiotic susceptibility testings.
幽门螺杆菌是胃内众多细菌种类中最常见的一种。由于其与胃腺癌存在因果关系,它被列为1类致癌物。幽门螺杆菌感染的流行病学特征是发展中国家和发达国家之间存在显著差异。由于抗生素耐药率高,幽门螺杆菌的治疗仍然是一个挑战。本研究的目的是调查从胃活检中分离出的幽门螺杆菌菌株对目前用于幽门螺杆菌感染治疗方案的不同抗生素的敏感性。
进行上消化道内镜检查,随后对胃活检组织进行快速尿素酶试验。阳性样本在微需氧条件下于特定培养基上培养,并对分离出的菌株进行抗生素敏感性测定。
尿素酶试验阳性的活检样本培养的阳性率为70%。经典三联疗法中使用的抗生素耐药率很高,即甲硝唑为92.8%,阿莫西林为50%,克拉霉素为32%。分离出的菌株对环丙沙星和左氧氟沙星敏感。
需要确定胃微生物群的作用及其对幽门螺杆菌相关病理的贡献。对于耐药幽门螺杆菌菌株导致的抗生素治疗失败问题,可以通过常规培养和抗生素敏感性检测来克服。