从巴基斯坦患者分离出的幽门螺杆菌菌株中抗菌药物耐药性的新趋势：阿莫西林和克拉霉素的考量需求

Emerging trends of antimicrobial resistance in Helicobacter pylori isolates obtained from Pakistani patients: The need for consideration of amoxicillin and clarithromycin.

作者信息

Siddiqui Taranum Ruba, Ahmed Waquaruddin, Arif Ambreen, Bibi Safia, Khan Adnan

机构信息

Pakistan Medical Research Council, Pakistan.

Toronto Western Hospital, Canada, Gastroenterology and Hepatology unit & Pakistan Medical Research Council, Pakistan.

出版信息

J Pak Med Assoc. 2016 Jun;66(6):710-6.

PMID:27339574

Abstract

OBJECTIVE

To present antimicrobial susceptibility profile of helicobacter pylori isolated from gastric biopsies of dyspeptic patients.

METHODS

The cross-sectional study was conducted from March 2008 to May 2013 at the Jinnah Postgraduate Medical Centre (JPMC), Karachi, and comprised patients with suspected peptic ulcer disease who underwent upper gastrointestinal endoscopy. Multiple gastric antral biopsies were taken. One sample was imbedded in the Campylobacter-like organism test, while other biopsies were processed for culture and confirmed on polymerase chain reaction. Isolates were subjected to antimicrobial susceptibility testing and minimum inhibitory concentrations of antimicrobial agents were estimated by Epsilometer test. SPSS 21 was used for statistical analysis.

RESULTS

Of the 889 samples available, 254(28.6%) were positive after campylo-like organism test, of them, 92(36.2%) isolates were cultured. Susceptibility test showed 90(97.8%) resistance to metronidazole, 25(30.1%) ofloxacin, 6(16.2%) levofloxacin, 14(15.2%) furazolidone, 5(5.4%) clarithromycin, 4(4.3%) tetracycline and 2(2.2%) isolates showed resistance to amoxicillin. Resistance to more than one drug was observed in 37(40.2%) isolates.

CONCLUSIONS

Low clarithromycin resistance was surprising since Pakistan is considered a hot bed of drug-resistant bacteria.

摘要

目的

呈现从消化不良患者胃活检标本中分离出的幽门螺杆菌的抗菌药物敏感性概况。

方法

2008年3月至2013年5月在卡拉奇的真纳研究生医学中心（JPMC）开展了这项横断面研究，研究对象为疑似消化性溃疡疾病且接受了上消化道内镜检查的患者。采集了多个胃窦活检标本。一个样本用于弯曲菌样菌检测，其他活检标本则进行培养并通过聚合酶链反应进行确认。对分离菌株进行抗菌药物敏感性测试，并通过Epsilometer试验估计抗菌药物的最低抑菌浓度。使用SPSS 21进行统计分析。

结果

在可得的889个样本中，弯曲菌样菌检测后有254个（28.6%）呈阳性，其中92个（36.2%）分离菌株培养成功。敏感性测试显示，对甲硝唑耐药的有90个（97.8%），对氧氟沙星耐药的有25个（30.1%），对左氧氟沙星耐药的有6个（16.2%），对呋喃唑酮耐药的有14个（15.2%），对克拉霉素耐药的有5个（5.4%），对四环素耐药的有4个（4.3%），对阿莫西林耐药的有2个（2.2%）。在37个（40.2%）分离菌株中观察到对不止一种药物耐药。