Song Zhiqiang, Zhang Jianzhong, He Lihua, Chen Minhu, Hou Xiaohua, Li Zhaoshen, Zhou Liya
Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Dig Liver Dis. 2014 Dec;46(12):1077-81. doi: 10.1016/j.dld.2014.08.038. Epub 2014 Sep 16.
Large-scale multi-region studies are urgently needed to provide comprehensive and up-to-date information on the antibiotic resistance of Helicobacter pylori that is critical for selecting the most optimal eradication regimens.
To determine the resistance patterns of Helicobacter pylori strains isolated from dyspeptic patients.
This is a prospective, multicentre, cross-sectional, observational study. Helicobacter pylori cultures were successful in 600 patients (never receiving eradication therapy) from Northern, Eastern, Middle, and Southern regions between 2008 and 2012. Resistance to amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, and rifampicin was determined by Epsilometer test.
The overall resistance rate was highest for metronidazole (403, 67.2%), followed by clarithromycin (225, 37.5%), levofloxacin (201, 33.5%), rifampicin (85, 14.2%), amoxicillin (41, 6.8%), and tetracycline (21, 3.5%). There were 16.3% isolates susceptible to all tested antibiotics, followed by mono-resistance (34.2%), double resistance (27.0%), triple resistance (16.8%), quadruple resistance (4.7%), quintuple resistance (0.7%) and sextuple resistance (0.3%). Independent factors influencing antibiotic resistance were gender (to levofloxacin), age (to levofloxacin), and endoscopic finding (to clarithromycin, metronidazole, and levofloxacin). Among the clarithromycin-resistant isolates, 75.6% and 48.0% were also resistant to metronidazole and levofloxacin, respectively.
Helicobacter pylori resistance to commonly used antibiotics in China is a very serious issue, due to the high resistance rate and general multiple resistance.
迫切需要开展大规模多地区研究，以提供关于幽门螺杆菌抗生素耐药性的全面且最新的信息，这对于选择最优化的根除方案至关重要。
确定从消化不良患者中分离出的幽门螺杆菌菌株的耐药模式。
这是一项前瞻性、多中心、横断面观察性研究。2008年至2012年期间，从北部、东部、中部和南部地区的600例患者（从未接受过根除治疗）中成功培养出幽门螺杆菌。采用Epsilometer试验测定对阿莫西林、克拉霉素、甲硝唑、左氧氟沙星、四环素和利福平的耐药性。
甲硝唑的总体耐药率最高（403例，67.2%），其次是克拉霉素（225例，37.5%）、左氧氟沙星（201例，33.5%）、利福平（85例，14.2%）、阿莫西林（41例，6.8%）和四环素（21例，3.5%）。16.3%的分离株对所有测试抗生素敏感，其次是单耐药（34.2%）、双重耐药（27.0%）、三重耐药（16.8%）、四重耐药（4.7%）、五重耐药（0.7%）和六重耐药（0.3%）。影响抗生素耐药性的独立因素为性别（对左氧氟沙星）、年龄（对左氧氟沙星）和内镜检查结果（对克拉霉素、甲硝唑和左氧氟沙星）。在克拉霉素耐药分离株中，分别有75.6%和48.0%也对甲硝唑和左氧氟沙星耐药。
由于幽门螺杆菌对常用抗生素的耐药率高且普遍存在多重耐药，在中国这是一个非常严重的问题。
