Boehnke Kevin F, Valdivieso Manuel, Bussalleu Alejandro, Sexton Rachael, Thompson Kathryn C, Osorio Soledad, Novoa Reyes Italo, Crowley John J, Baker Laurence H, Xi Chuanwu
Department of Environmental Health Sciences, School of Public Health.
Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Infect Drug Resist. 2017 Mar 10;10:85-90. doi: 10.2147/IDR.S123798. eCollection 2017.
Gastric carcinoma is the most common cancer and cause of cancer mortality in Peru. , a bacterium that colonizes the human stomach, is a Group 1 carcinogen due to its causal relationship to gastric carcinoma. While eradication of can help prevent gastric cancer, characterizing regional antibiotic resistance patterns is necessary to determine targeted treatment for each region. Thus, we examined primary antibiotic resistance in clinical isolates of in Lima, Peru.
strains were isolated from gastric biopsies of patients with histologically proven infection. Primary antibiotic resistance among isolates was examined using E-test strips. Isolates were examined for the presence of the pathogenicity island and the m1/m2 alleles via polymerase chain reaction.
Seventy-six isolates were recovered from gastric biopsies. Clinical isolates showed evidence of antibiotic resistance to 1 (27.6%, n=21/76), 2 (28.9%, n=22/76), or ≥3 antibiotics (40.8%). Of 76 isolates, eight (10.5%) were resistant to amoxicillin and clarithromycin, which are part of the standard triple therapy for infection. No trends were seen between the presence of , m1, or m2 and antibiotic resistance.
The rate of antibiotic resistance among isolates in Lima, Peru, is higher than expected and presents cause for concern. To develop more targeted eradication therapies for in Peru, more research is needed to better characterize antibiotic resistance among a larger number of clinical isolates prospectively.
胃癌是秘鲁最常见的癌症及癌症死亡原因。幽门螺杆菌是一种寄生于人类胃部的细菌，因其与胃癌的因果关系而被列为1类致癌物。虽然根除幽门螺杆菌有助于预防胃癌，但确定各地区的抗生素耐药模式对于制定针对性治疗方案很有必要。因此，我们研究了秘鲁利马临床分离的幽门螺杆菌的主要抗生素耐药情况。
从组织学确诊为幽门螺杆菌感染患者的胃活检标本中分离菌株。使用E-test试纸检测分离菌株的主要抗生素耐药情况。通过聚合酶链反应检测分离菌株中是否存在cag致病岛及vacA m1/m2等位基因。
从胃活检标本中分离出76株菌株。临床分离菌株显示出对1种抗生素（27.6%，n = 21/76）、2种抗生素（28.9%，n = 22/76）或≥3种抗生素（40.8%）耐药的证据。在76株分离菌株中，有8株（10.5%）对阿莫西林和克拉霉素耐药，而这两种药物是幽门螺杆菌感染标准三联疗法的组成部分。cagA、vacA m1或vacA m2的存在与抗生素耐药之间未发现明显趋势。
秘鲁利马幽门螺杆菌分离菌株的抗生素耐药率高于预期，令人担忧。为了开发更具针对性的秘鲁幽门螺杆菌根除疗法，需要开展更多研究，以便前瞻性地更好地描述大量临床分离菌株中的抗生素耐药情况。
