Andreev D N, Maev I V, Kucheryavyy Y A
Yevdokimov Moscow State University of Medicine and Dentistry.
Ter Arkh. 2020 Dec 26;92(11):24-30.
Systematization of data on antibiotic resistance of Helicobacter pylori in Russia over the past 10 years.
A search for studies were carried out in electronic databases MEDLINE/PubMed, EMBASE, Cochrane, Russian Science Citation Index. We analyzed the papers published over the past 10 years (2011 to 2020). In the final analysis, publications were selected from periodical peer-reviewed foreign and Russian publications, in which validated tests for assessing the microorganism resistance were used with detailed descriptive statistics, which allows the obtained data to be included in the meta-analysis.
The final analysis included 11 studies (808 isolates). H. pylori resistance to clarithromycin was 10.39% (95% confidence interval CI 7.10314.219), metronidazole 33.95% (95% CI 15.32955.639), amoxicillin 1.35% (95% CI 0.281 3.202), levofloxacin 20.0% (95% CI 12.63728.574), tetracycline 0.98% (95% CI 0.3532.163). Double clarithromycin-metronidazole resistance was reported in 2.7% (95% CI 1.1364.345).
This meta-analysis is the first analytical work that allows objectifying the current structure of H. pylori antibiotic resistance in the Russian Federation. The data obtained in the analysis of publications over the past 10 years indicate a low resistance of the microorganism to clarithromycin (less than the regulated threshold of 15%), which allows us to consider the triple regimen of eradication therapy as a first-line therapy in our country.
对俄罗斯过去10年幽门螺杆菌抗生素耐药性数据进行系统化整理。
在电子数据库MEDLINE/PubMed、EMBASE、Cochrane、俄罗斯科学引文索引中检索相关研究。我们分析了过去10年(2011年至2020年)发表的论文。在最终分析中,从国内外同行评审的期刊出版物中选取了使用经过验证的评估微生物耐药性测试且具有详细描述性统计数据的文献,以便将所得数据纳入荟萃分析。
最终分析纳入了11项研究(808株分离株)。幽门螺杆菌对克拉霉素的耐药率为10.39%(95%置信区间CI 7.103 - 14.219),对甲硝唑为33.95%(95% CI 15.329 - 55.639),对阿莫西林为1.35%(95% CI 0.281 - 3.202),对左氧氟沙星为20.0%(95% CI 12.637 - 28.574),对四环素为0.98%(95% CI 0.353 - 2.163)。克拉霉素 - 甲硝唑双重耐药率为2.7%(95% CI 1.136 - 4.345)。
这项荟萃分析是第一项能够客观呈现俄罗斯联邦幽门螺杆菌抗生素耐药性当前结构的分析工作。对过去10年出版物分析所得数据表明,该微生物对克拉霉素的耐药性较低(低于规定阈值15%),这使我们能够将根除治疗的三联疗法视为我国的一线治疗方案。