Division of Gastroentero-Hepatology, Department of Internal Medicine, Faculty of Medicine-Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya, Indonesia.
Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.
Gut Liver. 2021 Sep 15;15(5):653-665. doi: 10.5009/gnl20019.
infects more than half the human population. However, the prevalence in Indonesia is low, as is the prevalence of gastric cancer. Hence, it could be instructive to compare these prevalence rates and their determining factors with those of countries that have high gastric cancer incidence. Ethnicity and genetic characteristics of are important determinants of the infection rate in Indonesia. The infection rate is higher in Bataknese, Papuans and Buginese than in Javanese, the predominant ethnic group. Ethnicity is also an important determinant of the genetic characteristics of . Analysis of CagA in the EPIYA segment showed that the predominant genotypes in Papuans, Bataknese and Buginese are ABB-, ABDand ABC-type CagA, respectively. Meanwhile, in the countries with high gastric cancer incidence, almost all strains had East Asian type CagA. An antibiotic susceptibility evaluation showed that the standard triple therapy can still be used with caution in several cities. There is a very high rate of resistance to second-line regimens such as levofloxacin and metronidazole. Recent studies have shown that furazolidone, rifabutin and sitafloxacin are potential alternative treatments for antibiotic-resistant infection in Indonesia. Rather than focusing on early detection and eradication as in countries with high gastric cancer prevalence, countries with low gastric cancer prevalence should focus on screening the several groups that have a high risk of gastric cancer.
感染了超过一半的人类。然而，印度尼西亚的流行率较低，胃癌的流行率也较低。因此，与胃癌发病率较高的国家相比，比较这些流行率及其决定因素可能具有启发性。 种族和遗传特征是决定印度尼西亚 感染率的重要因素。在巴塔克人、巴布亚人和布吉人中，感染率高于占主导地位的爪哇人。种族也是 的遗传特征的重要决定因素。对 EPIYA 片段中的 CagA 进行分析表明，巴布亚人、巴塔克人和布吉人中主要的基因型分别为 ABB-、ABD 和 ABC 型 CagA。同时，在胃癌发病率较高的国家，几乎所有菌株都具有东亚型 CagA。抗生素药敏试验表明，标准三联疗法在几个城市仍可谨慎使用。二线方案如左氧氟沙星和甲硝唑的耐药率非常高。最近的研究表明，呋喃唑酮、利福布汀和西他沙星可能是印度尼西亚抗生素耐药 感染的潜在替代治疗方法。与胃癌流行率较高的国家关注早期检测和根除不同，胃癌流行率较低的国家应关注具有较高胃癌风险的几个群体进行筛查。
