Gościniak Grażyna, Biernat Monika M, Bińkowska Aldona, Kus Agnieszka, Iwańczak Barbara
Department of Microbiology, Wroclaw Medical University, Poland.
2nd Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2017 Mar-Apr;26(2):263-268. doi: 10.17219/acem/67716.
Helicobacter pylori (H. pylori) infection can occur as a mixed infection caused by several strains of H. pylori.
The aim of the study was to determine the frequency of colonization of the gastric mucosa by strains of H. pylori with different susceptibility to antimicrobial agents.
The study was carried out on gastric biopsies taken from 54 previously untreated Polish children and adolescents. Of the 15 positive cultures, from each primary medium, 6 single H. pylori colonies were isolated, making a total of 90 isolates, and the susceptibility to metronidazole (MZ), amoxicillin (AC) and clarithromycin (CH) was determined by E-test method. The presence of the cagA gene and vacA alleles (s1, s2, m1, m2) was determined by PCR.
Positive culture for H. pylori was noted in 15/54 (27.7%) of patients. All H. pylori isolates were susceptible to AC, 27.8% were resistant to MZ and 38.9% to CH. The results showed 7/15 (46.7%) of children were infected with H. pylori strains with antibiotic heteroresistance, resistant to CH (5/15, 33.3%) and to MZ (2/15, 13.3%). The cagA + vacA s1/m2 combination was predominant genotype among detected H. pylori strains. The isolates possessing different antimicrobial susceptibility profiles in the same patient were identified.
Microbiological analyses confirmed the presence of isolates possessing different antimicrobial susceptibility profiles in 47% of examined children with H. pylori infection. Different antimicrobial susceptibility profiles of H. pylori isolates detected in the same patient may influence the success of eradication therapy.
幽门螺杆菌（H. pylori）感染可能是由几种幽门螺杆菌菌株引起的混合感染。
本研究旨在确定对抗菌药物敏感性不同的幽门螺杆菌菌株在胃黏膜中的定植频率。
对54名未经治疗的波兰儿童和青少年的胃活检组织进行研究。在15份阳性培养物中，从每种基础培养基中分离出6个单一的幽门螺杆菌菌落，共90株分离株，采用E-test法测定其对甲硝唑（MZ）、阿莫西林（AC）和克拉霉素（CH）的敏感性。通过PCR检测cagA基因和vacA等位基因（s1、s2、m1、m2）的存在情况。
15/54（27.7%）的患者幽门螺杆菌培养呈阳性。所有幽门螺杆菌分离株对AC敏感，27.8%对MZ耐药，38.9%对CH耐药。结果显示，7/15（46.7%）的儿童感染了具有抗生素异质性耐药的幽门螺杆菌菌株，对CH耐药（5/15，33.3%），对MZ耐药（2/15，13.3%）。cagA + vacA s1/m2组合是检测到的幽门螺杆菌菌株中的主要基因型。在同一患者中鉴定出具有不同抗菌药物敏感性谱的分离株。
微生物学分析证实，在47%的幽门螺杆菌感染患儿中存在具有不同抗菌药物敏感性谱的分离株。在同一患者中检测到的幽门螺杆菌分离株不同的抗菌药物敏感性谱可能会影响根除治疗的成功率。
