School of Medicine, Trinity College Dublin, Dublin 2, Ireland.
Curr Opin Gastroenterol. 2019 Jan;35(1):6-13. doi: 10.1097/MOG.0000000000000497.
Helicobacter pylori eradication rates have fallen in recent years, mainly because of the emergence of antibiotic-resistant infections. Indeed the WHO has recently designated clarithromycin-resistant H. pylori infection a high priority for antibiotic resistance research and development. This review aims to discuss the most up-to-date information on the methods to detect H. pylori antibiotic resistance, the recent data on resistance rates, and the most appropriate treatment strategies to overcome antibiotic resistance.
There has been active research into the development and assessment of genotypic diagnostic assays for both the invasive and noninvasive detection of antibiotic-resistant infection. There are regional variations in the prevalence of H. pylori antibiotic resistance. Primary resistance rates in general are on the rise and high rates of clarithromycin resistance (>15%) have been reported in many parts of the world.
Optimizing antimicrobial susceptibility testing by both invasive and noninvasive means is crucial to accurately evaluate resistance rates for the optimization of both regional and personalized H. pylori treatment strategies.
近年来,由于抗生素耐药感染的出现,幽门螺杆菌的根除率有所下降。事实上,世界卫生组织(WHO)最近将克拉霉素耐药幽门螺杆菌感染列为抗生素耐药性研究和开发的重点。本文旨在讨论检测幽门螺杆菌抗生素耐药性的最新方法、最新耐药率数据以及克服抗生素耐药性的最佳治疗策略。
人们积极研究开发用于检测抗生素耐药性的侵袭性和非侵袭性基因诊断检测方法。幽门螺杆菌抗生素耐药性存在地区差异。总的来说,原发性耐药率呈上升趋势,在世界许多地区都报告了高克拉霉素耐药率(>15%)。
通过侵袭性和非侵袭性手段优化抗菌药物敏感性测试对于准确评估耐药率至关重要,这有助于优化区域性和个体化的幽门螺杆菌治疗策略。