采用欧洲抗菌药物敏感性试验委员会（EUCAST）的折点，比较幽门螺杆菌临床分离株对6种抗菌药物的敏感性与先前使用的折点。
Antimicrobial susceptibility of 6 antimicrobial agents in Helicobacter pylori clinical isolates by using EUCAST breakpoints compared with previously used breakpoints.
作者信息
Alarcón Teresa, Urruzuno Pedro, Martínez Maria Josefa, Domingo Diego, Llorca Laura, Correa Ana, López-Brea Manuel
机构信息
Servicio de Microbiologia, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain; Departamento de Medicina Preventiva, Salud Pública y Microbiologia, Facultad de Medicina, Universidad Autónoma de Madrid, Spain.
Unidad de Gastroenterología Pediátrica, Hospital Universitario Doce de Octubre, Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain.
出版信息
Enferm Infecc Microbiol Clin. 2017 May;35(5):278-282. doi: 10.1016/j.eimc.2016.02.010. Epub 2016 Mar 24.
INTRODUCTION
The aim of this study was to determine the differences in percentage resistance in H. pylori clinical isolates using EUCAST breakpoints compared with previously used breakpoints. MIC value distribution in H. pylori clinical isolates was also studied.
METHODS
Susceptibility to amoxicillin, tetracycline, metronidazole, clarithromycin, rifampicin and levofloxacin was performed by E-test in 824 H. pylori clinical isolates. EUCAST and previous breakpoints defined resistance as follows: MIC >0.12mg/L and ≥2mg/L for amoxicillin, >8mg/L and ≥8mg/L for metronidazole, >0.5mg/L and ≥1mg/L for clarithromycin, >1mg/L and ≥32mg/L for rifampicin, and >1mg/L and ≥4mg/L for tetracycline and >1mg/L levofloxacin.
RESULTS
Overall resistance rate by EUCAST and by previous breakpoints was 8.5% and 3.2% for amoxicillin, 0.6% and 0.1% for tetracycline, 39.2% and 39.7% for metronidazole, 51.2% and 51.2% for clarithromycin, 32% and 3.1% for rifampicin, and 6.7% and 6.7% for levofloxacin.
CONCLUSIONS
When using the different breakpoints for antimicrobial susceptibility testing, similar results were found with most antibiotics tested (tetracycline, metronidazole, clarithromycin, and levofloxacin), except for amoxicillin and rifampicin.
引言
本研究旨在确定与先前使用的断点相比，使用欧洲抗菌药物敏感性试验委员会（EUCAST）断点时幽门螺杆菌临床分离株的耐药百分比差异。还研究了幽门螺杆菌临床分离株的最低抑菌浓度（MIC）值分布。
方法
采用E试验对824株幽门螺杆菌临床分离株进行阿莫西林、四环素、甲硝唑、克拉霉素、利福平和左氧氟沙星的敏感性检测。EUCAST和先前的断点将耐药定义如下：阿莫西林的MIC>0.12mg/L和≥2mg/L，甲硝唑的MIC>8mg/L和≥8mg/L，克拉霉素的MIC>0.5mg/L和≥1mg/L，利福平的MIC>1mg/L和≥32mg/L，四环素的MIC>1mg/L和≥4mg/L，左氧氟沙星的MIC>1mg/L。
结果
根据EUCAST和先前的断点，阿莫西林的总体耐药率分别为8.5%和3.2%，四环素为0.6%和0.1%，甲硝唑为39.2%和39.7%，克拉霉素为51.2%和51.2%，利福平为32%和3.1%，左氧氟沙星为6.7%和6.7%。
结论
在使用不同的抗菌药物敏感性试验断点时，除阿莫西林和利福平外，大多数受试抗生素（四环素、甲硝唑、克拉霉素和左氧氟沙星）的结果相似。
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