Hu Yi, Zhu Yin, Lu Nong-Hua
Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, 17 YongWaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China.
Dig Dis Sci. 2017 May;62(5):1146-1154. doi: 10.1007/s10620-017-4536-8. Epub 2017 Mar 17.
Antibiotic resistance is the most important factor leading to the failure of eradication regimens; thus, it is important to obtain regional antibiotic resistance information. This review focuses on the prevalence of Helicobacter pylori primary resistance to clarithromycin, metronidazole, amoxicillin, levofloxacin, tetracycline, and furazolidone in China.
We searched the PubMed, EMBASE, the China National Knowledge Infrastructure, and Chinese Biomedical databases from the earliest date of each database to October 2016. The search terms included the following: H. pylori, antibiotic (including clarithromycin, metronidazole, amoxicillin, levofloxacin, tetracycline, and furazolidone) resistance with or without China or different regions of China. The data analysis was performed using MedCalc 15.2.2. Each article was weighted according to the number of isolated H. pylori strains. A pooled proportion analysis was performed.
Twenty-three studies (14 studies in English and 9 in Chinese) were included in this review. A total of 6274, 6418, 3921, 5468, 2802, and 275 H. pylori strains were included in this review to evaluate the prevalence of H. pylori primary resistance to clarithromycin, metronidazole, levofloxacin, amoxicillin, tetracycline, and furazolidone, respectively. Overall, the primary resistance rates of clarithromycin, metronidazole, levofloxacin, amoxicillin, tetracycline, and furazolidone were 28.9, 63.8, 28.0, 3.1, 3.9, and 1.7%, respectively.
In China, the prevalence of H. pylori primary resistance to clarithromycin, metronidazole, and levofloxacin was high and increased over time, whereas the resistance rates to amoxicillin, tetracycline, and furazolidone were low and stable over time.
抗生素耐药性是导致根除治疗方案失败的最重要因素；因此，获取地区性抗生素耐药信息很重要。本综述聚焦于中国幽门螺杆菌对克拉霉素、甲硝唑、阿莫西林、左氧氟沙星、四环素和呋喃唑酮的原发性耐药率。
我们检索了PubMed、EMBASE、中国知网和中国生物医学数据库，检索时间从各数据库最早收录日期至2016年10月。检索词包括：幽门螺杆菌、抗生素（包括克拉霉素、甲硝唑、阿莫西林、左氧氟沙星、四环素和呋喃唑酮）耐药性，同时包含或不包含中国或中国不同地区。使用MedCalc 15.2.2进行数据分析。每篇文章根据分离出的幽门螺杆菌菌株数量进行加权。进行合并比例分析。
本综述纳入了23项研究（14项英文研究和9项中文研究）。本综述共纳入了6274、6418、3921、5468、2802和275株幽门螺杆菌菌株，分别用于评估幽门螺杆菌对克拉霉素、甲硝唑、左氧氟沙星、阿莫西林、四环素和呋喃唑酮的原发性耐药率。总体而言，克拉霉素、甲硝唑、左氧氟沙星、阿莫西林、四环素和呋喃唑酮的原发性耐药率分别为28.9%、63.8%、28.0%、3.1%、3.9%和1.7%。
在中国，幽门螺杆菌对克拉霉素、甲硝唑和左氧氟沙星的原发性耐药率较高且随时间增加，而对阿莫西林、四环素和呋喃唑酮的耐药率较低且随时间保持稳定。
