Kageyama Chihiro, Sato Mayu, Sakae Hiroyuki, Obayashi Yuka, Kawahara Yoshiro, Mima Takehiko, Matsushita Osamu, Yokota Kenji, Mizuno Motowo, Okada Hiroyuki
Graduate School of Health Science, Medical Technology, Okayama University, Okayama 700-8558, Japan,
Gastroenterology and Hepatology, Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan.
Infect Drug Resist. 2019 Mar 12;12:597-602. doi: 10.2147/IDR.S196452. eCollection 2019.
Eradication effectively prevents -associated diseases; however, antibiotic resistance has increased throughout Japan and worldwide. This study aimed to assess rates of resistance to antibiotics; amoxicillin, clarithromycin and metronidazole in a University Hospital in Japan.
(208 strains) were isolated from patients at the Okayama University Hospital in Japan. The minimum inhibitory concentrations (MIC) were determined using the mean values of the E-test to determine the antimicrobial susceptibilities of the strains. Sequencing and gene analysis were performed to analyze resistance genes to clarithromycin and amoxicillin.
Rates of amoxicillin, clarithromycin, and metronidazole resistance were 13%, 48%, and 49%, respectively. Genetic analysis indicated that the A2143G point mutation in 23S rDNA is closely associated with the MIC of clarithromycin. The MIC in amoxicillin-resistant strains increased with an increase in the number of PBP1A amino acids mutations.
Genetic analysis for resistant strains is not clinically effective in cases of amoxicillin resistance. Numerous bacteria with already high antibiotic resistance rates have been isolated in large hospitals such as a University Hospital. For effective eradication therapy, MIC measurement should be considered via several methods.
根除治疗可有效预防相关疾病；然而，在日本乃至全球范围内，抗生素耐药性都有所增加。本研究旨在评估日本一家大学医院中分离出的菌株对阿莫西林、克拉霉素和甲硝唑的耐药率。
从日本冈山大学医院的患者中分离出208株菌株。使用E-test的平均值测定最低抑菌浓度（MIC），以确定菌株的抗菌敏感性。进行测序和基因分析，以分析对克拉霉素和阿莫西林的耐药基因。
阿莫西林、克拉霉素和甲硝唑的耐药率分别为13%、48%和49%。基因分析表明，23S rDNA中的A2143G点突变与克拉霉素的MIC密切相关。阿莫西林耐药菌株的MIC随着PBP1A氨基酸突变数量的增加而升高。
对于阿莫西林耐药的情况，耐药菌株的基因分析在临床上并不有效。在大学医院等大型医院中已分离出许多耐药率本就很高的细菌。为了进行有效的根除治疗，应考虑通过多种方法测量MIC。
