Park Jae Yong, Shin Tae-Seop, Kim Ji Hyun, Yoon Hong Jip, Kim Beom Jin, Kim Jae Gyu
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul 06974, Korea.
MD Healthcare Inc., Seoul 03923, Korea.
Antibiotics (Basel). 2020 Sep 27;9(10):646. doi: 10.3390/antibiotics9100646.
Antimicrobial resistance is one of the major factors determining the efficacy of eradication therapy. This study aimed to estimate the recent prevalence of multidrug resistance of and its impact on eradication in Korea. A total of 174 patients were prospectively enrolled at Chung-Ang University Hospital from 2017 to 2019. strains were isolated from the gastric body and antrum. The minimum inhibitory concentrations of antibiotics were determined by the serial twofold agar dilution method. Eradication results were reviewed and analyzed in connection with antibiotic resistance. The prevalence of infection was 51.7% (90/174). The culture success rate was 77.8% (70/90). The resistance rates for clarithromycin, metronidazole, amoxicillin, tetracycline, levofloxacin, and moxifloxacin were 28.6% (20/70), 27.1% (19/70), 20.0% (14/70), 18.6% (13/70), 42.9% (30/70), and 42.9% (30/70), respectively. The multidrug resistance (resistance to two or more classes of antimicrobials) rate was 42.9% (30/70). Dual resistance to clarithromycin and metronidazole was confirmed in 8.6% (6/70). Eradication with a first-line treatment was successful in 75% (36/48), and those who received second-line treatment all achieved successful eradication. The rate of multidrug resistance is increasing, and standard triple therapy (STT) is no longer an acceptable first-line option for eradication in Korea.
抗菌药物耐药性是决定根除治疗疗效的主要因素之一。本研究旨在评估韩国近期多重耐药的流行情况及其对根除治疗的影响。2017年至2019年，共有174例患者前瞻性纳入中央大学医院。从胃体和胃窦分离出菌株。采用连续两倍琼脂稀释法测定抗生素的最低抑菌浓度。结合抗生素耐药性对根除结果进行回顾和分析。感染率为51.7%（90/174）。培养成功率为77.8%（70/90）。克拉霉素、甲硝唑、阿莫西林、四环素、左氧氟沙星和莫西沙星的耐药率分别为28.6%（20/70）、27.1%（19/70）、20.0%（14/70）、18.6%（13/70）、42.9%（30/70）和42.9%（30/70）。多重耐药（对两类或更多类抗菌药物耐药）率为42.9%（30/70）。克拉霉素和甲硝唑双重耐药率为8.6%（6/70）。一线治疗根除成功率为75%（36/48），接受二线治疗的患者均成功根除。多重耐药率正在上升，标准三联疗法（STT）不再是韩国根除的可接受一线选择。
