德国中部地区幽门螺杆菌的抗生素敏感性及其与根除治疗次数的关系。

Antibiotic susceptibility of Helicobacter pylori in central Germany and its relationship with the number of eradication therapies.

机构信息

aDepartment of Gastroenterology, Hepatology and Infectious Diseases bInstitute of Medical Microbiology, Otto-von-Guericke-University of Magdeburg cMedical Laboratory for Clinical Chemistry, Microbiology and Infectious Diseases, Department of Molecular Genetics, Magdeburg, Germany.

出版信息

Eur J Gastroenterol Hepatol. 2013 Nov;25(11):1257-60. doi: 10.1097/MEG.0b013e3283643491.

DOI:10.1097/MEG.0b013e3283643491

PMID:23863261

Abstract

OBJECTIVES

Helicobacter pylori eradication rates show a constant decline over the last few years. The main reason for H. pylori treatment failure is the increasing antibiotic resistance.We assessed antibiotic susceptibility of H. pylori in a region of mid-Germany and analyzed the relationship of antibiotic resistance with the number of eradication therapies over a period of 7 years (2005-2012).

METHODS

H. pylori strains were isolated from 436 patients who underwent gastroscopy for different clinical indications. Susceptibility to amoxicillin, clarithromycin, metronidazole, tetracycline, levofloxacin, and rifabutin was determined using the E-test.

RESULTS

Primary, secondary, and tertiary resistances against clarithromycin were 7.5, 63.2, and 75.4%, respectively. Primary, secondary, and tertiary resistances to levofloxacin were 11.7, 17.6, and 36.4% and to metronidazole were 32.7, 63.2, and 80.1%, respectively. The resistance rates against tetracycline and rifabutin were comparatively low (<5%), even in patients with previous exposure to these antibiotics. Resistance to rifabutin increased to 6.2% in patients who received more than two previous eradication therapies. Amoxicillin resistance was not detectable in all patients.

CONCLUSION

In our region, we observed a stable, but constantly increasing, resistance rate to antibiotics commonly used for the treatment of H. pylori infection. Knowledge of the local antibiotic resistance rates is essential for developing successful treatment strategies for H. pylori eradication.

摘要

目的

近年来，幽门螺杆菌的根除率呈持续下降趋势。幽门螺杆菌治疗失败的主要原因是抗生素耐药性的增加。我们评估了德国中部地区幽门螺杆菌的抗生素敏感性，并分析了 7 年间（2005-2012 年）抗生素耐药性与根除治疗次数的关系。

方法

从 436 名因不同临床指征行胃镜检查的患者中分离出幽门螺杆菌菌株。采用 E 试验法测定阿莫西林、克拉霉素、甲硝唑、四环素、左氧氟沙星和利福布汀的药敏性。

结果

克拉霉素的原发、继发和继发耐药率分别为 7.5%、63.2%和 75.4%。左氧氟沙星的原发、继发和继发耐药率分别为 11.7%、17.6%和 36.4%，甲硝唑的耐药率分别为 32.7%、63.2%和 80.1%。即使在先前接触过这些抗生素的患者中，对四环素和利福布汀的耐药率也相对较低（<5%）。接受超过两次根除治疗的患者中，利福布汀的耐药率增加到 6.2%。所有患者均未检出阿莫西林耐药性。