Gastroenterology Unit, Department of Medicine, Faculty of Medicine, Thammasat University Hospital, Pathumthani, Thailand.
Digestive diseases Research Center (DRC), Thammasat University, Pathumthani, Thailand.
Asian Pac J Cancer Prev. 2020 May 1;21(5):1409-1413. doi: 10.31557/APJCP.2020.21.5.1409.
Gastric cancer, which is the leading cause of cancer mortality in Cambodia, can be prevented by Helicobacter pylori (H. pylori) eradication. There is limited data about H. pylori strains in Cambodia. This study aimed to evaluate H. pylori prevalence and antibiotic resistance in Koh Kong, Cambodia.
118 Cambodian dyspeptic patients were scheduled to enter this study and 58 were enrolled between July and September 2019. All patients underwent upper GI endoscopy. 3 gastric biopsies were obtained for rapid urease test, H. pylori culture with E-test and GenoType® HelicoDr (Hain Lifescience factory, Germany). 3-mL blood sample was collected for CYP2C19 genotyping.
58 subjects were enrolled (40 females, 18 males, mean age 43.8 years). Overall H. pylori prevalence was 31.0%. Antibiotic resistance rates were 78.6% for metronidazole, 50.0% for fluoroquinolones, and 27.8% for clarithromycin. There was no amoxicillin and tetracycline resistance. More than half of H. pylori strains (57.1%) were multidrug-resistant. Most (35.7%) were resistant to metronidazole and quinolone. Poor, intermediate and rapid metabolizers were 5.5%, 38.9% and 55.6%, respectively.
H. pylori infection remains common infection in Cambodia. High prevalence of clarithromycin, metronidazole, levofloxacin and multidrug-resistant H. pylori is still major problems in Cambodia. Treatment regimens without clarithromycin and quinolone such as 14-day bismuth-based quadruple therapy might be an appropriate choice for H. pylori eradication in this particular area.
胃癌是柬埔寨癌症死亡的主要原因，可以通过根除幽门螺杆菌（H. pylori）来预防。关于柬埔寨的 H. pylori 菌株的数据有限。本研究旨在评估柬埔寨戈公省的 H. pylori 流行率和抗生素耐药性。
118 名柬埔寨消化不良患者计划参与本研究，其中 58 名患者于 2019 年 7 月至 9 月入组。所有患者均接受上消化道内镜检查。取 3 份胃活检标本进行快速尿素酶试验、H. pylori 培养和 E-试验以及 GenoType®HelicoDr（德国 Hain Lifescience 工厂）。采集 3-mL 血样进行 CYP2C19 基因分型。
共纳入 58 名受试者（40 名女性，18 名男性，平均年龄 43.8 岁）。总体 H. pylori 患病率为 31.0%。抗生素耐药率分别为：甲硝唑 78.6%，氟喹诺酮类 50.0%，克拉霉素 27.8%。未发现阿莫西林和四环素耐药。超过一半的 H. pylori 菌株（57.1%）为多药耐药菌株。大多数（35.7%）对甲硝唑和喹诺酮类耐药。差、中、快代谢者分别为 5.5%、38.9%和 55.6%。
H. pylori 感染在柬埔寨仍然是常见感染。克拉霉素、甲硝唑、左氧氟沙星和多药耐药 H. pylori 的高流行率仍然是柬埔寨的主要问题。在该特定地区，不含克拉霉素和喹诺酮类的 14 天铋剂四联疗法可能是根除 H. pylori 的合适选择。
