Eisig Jaime Natan, Silva Fernando Marcuz, Barbuti Ricardo Correa, Navarro-Rodriguez Tomás, Moraes-Filho Joaquim Prado P, Pedrazzoli José
Serviço de Gastroenterologia Clínica, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brasil.
Arq Gastroenterol. 2011 Oct-Dec;48(4):261-4. doi: 10.1590/s0004-28032011000400008.
The antibiotic susceptibility is the cornerstone for the eradication therapies of Helicobacter pylori.
To evaluate the prevalence of primary resistance of H. pylori was evaluated in an urban Brazilian population.
H. pylori isolates were obtained from patients submitted to an upper gastrointestinal endoscopy for the evaluation of dyspeptic symptoms. Biopsies from antrum, corpus and fundus were taken to determine the antibiotic susceptibility of H. pylori isolates. The minimal inhibitory concentration of furazolidone and bismuth were routinely determined by agar dilution method and the minimal inhibitory for amoxicillin, clarithromycin, tetracycline, levofloxacin, and metronidazole were routinely determined with the E-test.
Fifty-four patients were included. In vitro antimicrobial susceptibility of H. pylori strains were obtained from 39 patients. Resistance to metronidazole was detected in 20 patients (51%), to clarithromycin in 3 patients (8%), to levofloxacin in 9 patients (23%) and to bismuth in 2 patients (5%). There was no observed resistance to amoxicillin, tetracycline or furazolidone.
Due to the low amoxicillin and clarithromycin resistance observed in this study, therapies using these antimicrobials remain appropriated first-line H. pylori therapy.
抗生素敏感性是幽门螺杆菌根除治疗的基石。
评估巴西城市人群中幽门螺杆菌的原发耐药率。
从因消化不良症状接受上消化道内镜检查的患者中获取幽门螺杆菌分离株。取胃窦、胃体和胃底的活检组织以确定幽门螺杆菌分离株的抗生素敏感性。呋喃唑酮和铋的最低抑菌浓度常规采用琼脂稀释法测定，阿莫西林、克拉霉素、四环素、左氧氟沙星和甲硝唑的最低抑菌浓度常规采用E-test法测定。
纳入54例患者。从39例患者中获得幽门螺杆菌菌株的体外抗菌药敏结果。20例患者（51%）检测到对甲硝唑耐药，3例患者（8%）对克拉霉素耐药，9例患者（23%）对左氧氟沙星耐药，2例患者（5%）对铋耐药。未观察到对阿莫西林、四环素或呋喃唑酮的耐药情况。
由于本研究中观察到的阿莫西林和克拉霉素耐药率较低，使用这些抗菌药物的治疗仍然是合适的幽门螺杆菌一线治疗方案。
