Zhong Zishao, Zhang Zhenyu, Wang Jing, Hu Yunlian, Mi Yang, He Bangshun, Zhang Yushu, Zhang Ximei, Xia Xingzhou, Huang Huang, Lai Yuexing, Lin Min, Su Chengxia, Zhang Zhiyi, Wu Zhengqi, Lu Linzhi, Zhang Beiping, Huang Suiping, Zhong Cailing, Zeng Xiaoming, Peng Yun, Chen Guangxia, Zhang Haihan, Zhou Guangqing, Liu Shiyu, Yang Changqing, Yan Lijuan, Chen Aojun, Zhang Guiying, Xu Ping, Wang Shukui, Zheng Pengyuan, Xu Shuchang, Gao Hengjun
Tongji Hospital, School of Medicine, Tongji University Shanghai, China.
Institute of Digestive Disease, School of Medicine, Tongji University Shanghai, China.
Am J Cancer Res. 2021 Oct 15;11(10):5027-5037. eCollection 2021.
antibiotic resistance is a serious concern in China, where it severely influences treatment for infection. To overcome this, it is essential to apply personalized therapies based on local or individual data on antibiotic-resistant phenotypes or genotypes. We conducted a large-scale multi-center study with a retrospective cross-sectional observational design to investigate the antibiotic-resistant phenotypes and genotypes of in China. Strains were isolated from the gastric biopsy samples of -infected patients from five different regions in China. The strains were tested for antibiotic-resistant phenotypes and genotypes, and the agreement between the two was assessed. In total, 4242 strains were isolated and cultured, with an 84.43% success rate. The primary and secondary antibiotic resistance rates of were 37.00% and 76.93% for clarithromycin, 34.21% and 61.58% for levofloxacin, 2.20% and 6.12% for amoxicillin, 1.61% and 3.11% for furazolidone, 1.18% and 3.31% for tetracycline, and 87.87% and 93.48% for metronidazole, respectively. The dual-resistance patterns for metronidazole/clarithromycin, metronidazole/levofloxacin, and clarithromycin/levofloxacin were 43.6%, 38.4%, and 26.1%, respectively. Clarithromycin- and levofloxacin-resistant phenotypes and genotypes showed satisfactory agreement. Based on these findings, clarithromycin- and levofloxacin-resistant genotype testing could partially replace traditional antibiotic susceptibility testing in China. Continuous monitoring and personalized treatments based on individual and local antibiotic-resistance data remain necessary.
抗生素耐药性在中国是一个严重问题，它严重影响感染治疗。为克服这一问题，基于当地或个体抗生素耐药表型或基因型数据应用个性化治疗至关重要。我们开展了一项大规模多中心研究，采用回顾性横断面观察设计，以调查中国幽门螺杆菌的抗生素耐药表型和基因型。菌株从中国五个不同地区幽门螺杆菌感染患者的胃活检样本中分离。对菌株进行抗生素耐药表型和基因型检测，并评估两者之间的一致性。总共分离并培养了4242株幽门螺杆菌，成功率为84.43%。幽门螺杆菌对克拉霉素的一级和二级抗生素耐药率分别为37.00%和76.93%，对左氧氟沙星为34.21%和61.58%，对阿莫西林为2.20%和6.12%，对呋喃唑酮为1.61%和3.11%，对四环素为1.18%和3.31%，对甲硝唑为87.87%和93.48%。甲硝唑/克拉霉素、甲硝唑/左氧氟沙星和克拉霉素/左氧氟沙星的双重耐药模式分别为43.6%、38.4%和26.1%。对克拉霉素和左氧氟沙星耐药的幽门螺杆菌表型和基因型显示出良好的一致性。基于这些发现，在中国，对克拉霉素和左氧氟沙星耐药的基因型检测可部分替代传统的抗生素敏感性检测。基于个体和当地幽门螺杆菌抗生素耐药数据的持续监测和个性化治疗仍然必要。
