Li Lan, Ke Yini, Yu Chaohui, Li Guogang, Yang Ningmin, Zhang Jianzhong, Li Youming
Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Department of Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Helicobacter. 2017 Jun;22(3). doi: 10.1111/hel.12373. Epub 2017 Jan 18.
To determine the prevalence of resistance to metronidazole, clarithromycin, levofloxacin, amoxicillin, and furazolidone in Helicobacter pylori isolated from Chinese children.
This multicenter retrospective study was conducted from January 2009 to December 2015. A total of 1746 isolates of H. pylori were collected from nine areas of Zhejiang province in the southeast coastal region of China. H. pylori strains were examined for antibiotics susceptibility by agar dilution method.
The resistance rates were 75.20% for metronidazole, 16.38% for clarithromycin, 6.70% for levofloxacin, 0.06% for amoxicillin, and 0.06% for furazolidone. The pattern of H. pylori antibiotic resistance demonstrated no significant changes in the rates of resistance to clarithromycin, amoxicillin, furazolidone, and metronidazole over 7 years. A significant trend of increasing resistance to metronidazole was observed as children aged, but a downward trend in clarithromycin resistance was observed as children aged. No difference in the resistance to other antibiotics was observed among different age groups. Also, there was no significant difference between male and female subjects in rates of resistance to these five types of antibiotics. The predominant dual resistance to metronidazole and clarithromycin was presented in 10.65% of the isolates.
The resistance rates of H. pylori in children from southeast coastal region of China were very high to metronidazole, moderate to clarithromycin and levofloxacin, and low to amoxicillin and furazolidone. It is important to continue monitoring the resistance profiles of H. pylori isolated in this region.
确定从中国儿童中分离出的幽门螺杆菌对甲硝唑、克拉霉素、左氧氟沙星、阿莫西林和呋喃唑酮的耐药率。
本多中心回顾性研究于2009年1月至2015年12月进行。从中国东南沿海地区浙江省的九个地区共收集了1746株幽门螺杆菌。采用琼脂稀释法检测幽门螺杆菌菌株的抗生素敏感性。
甲硝唑耐药率为75.20%，克拉霉素为16.38%，左氧氟沙星为6.70%，阿莫西林为0.06%，呋喃唑酮为0.06%。幽门螺杆菌抗生素耐药模式显示，在7年期间，对克拉霉素、阿莫西林、呋喃唑酮和甲硝唑的耐药率没有显著变化。随着儿童年龄增长，观察到对甲硝唑耐药率有显著上升趋势，但对克拉霉素耐药率有下降趋势。不同年龄组对其他抗生素的耐药性没有差异。此外，在这五种抗生素的耐药率方面，男性和女性受试者之间也没有显著差异。10.65%的分离株表现出对甲硝唑和克拉霉素的主要双重耐药。
中国东南沿海地区儿童幽门螺杆菌对甲硝唑耐药率非常高，对克拉霉素和左氧氟沙星耐药率中等，对阿莫西林和呋喃唑酮耐药率低。持续监测该地区分离出的幽门螺杆菌的耐药情况很重要。
