Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Sanmen People's Hospital, Taizhou, China.
Turk J Gastroenterol. 2021 Dec;32(12):996-1002. doi: 10.5152/tjg.2020.19354.
To determine the prevalence of Helicobacter pylori infection and the antibiotic susceptibility of H. pylori in patients after partial gastrectomy.
Patients who underwent gastroscopy from January 2009 to November 2017 and had a history of partial gastrectomy were retrospectively enrolled in the remnant stomach group. Contemporary non-gastrectomized patients with an endoscopic diagnosis of chronic gastritis were enrolled in the non-operated stomach group. The detection of H. pylori infection was performed by culture and histology. The in vitro antimicrobial susceptibility was examined by the agar dilution method on strains from gastric biopsies.
In this study, a total of 728 gastrectomized and 5035 non-gastrectomized patients were included. There was a significantly lower prevalence of H. pylori infection in the gastric-remnant patients (8.65%) than in the non-gastrectomized patients (17.76%) (P < .001) with the diagnostic method of culture. In the gastric-remnant patients, the H. pylori strains had resistance rates to metronidazole, clarithromycin, levofloxacin, amoxicillin, and furazolidone of 100%, 20.63%, 22.22%, 0%, and 0%, respectively. In the nongastrectomized patients, H. pylori resistance to metronidazole, clarithromycin, levofloxacin, amoxicillin, and furazolidone was 90.49%, 24.61%, 21.70%, 0.22%, and 0.11%, respectively. Gastric-remnant patients had a significantly higher metronidazole resistance rate than non-gastrectomized patients (P = .005). Moreover, no significant changes in the resistance to 5 antibiotics were observed among the gastric-remnant patients from different age, gender, and surgical indication groups.
Patients after partial gastrectomy showed a lower prevalence of H. pylori infection. Gastric-remnant patients were more likely to harbor metronidazole-resistant H. pylori strains.
确定胃部分切除术后患者中幽门螺杆菌感染的流行率以及幽门螺杆菌对抗生素的敏感性。
回顾性纳入 2009 年 1 月至 2017 年 11 月间接受胃镜检查且有胃部分切除手术史的患者进入残胃组。同期纳入内镜诊断为慢性胃炎且未经手术治疗的患者进入非手术胃组。通过培养和组织学检查检测幽门螺杆菌感染。通过琼脂稀释法检测胃活检标本中菌株的体外抗菌药物敏感性。
本研究共纳入 728 例胃切除患者和 5035 例非胃切除患者。与非胃切除患者（17.76%）相比，残胃患者（8.65%）幽门螺杆菌感染的流行率显著降低（P<0.001），这是采用培养方法的结果。在残胃患者中，幽门螺杆菌菌株对甲硝唑、克拉霉素、左氧氟沙星、阿莫西林和呋喃唑酮的耐药率分别为 100%、20.63%、22.22%、0%和 0%。在非胃切除患者中，幽门螺杆菌对甲硝唑、克拉霉素、左氧氟沙星、阿莫西林和呋喃唑酮的耐药率分别为 90.49%、24.61%、21.70%、0.22%和 0.11%。残胃患者的甲硝唑耐药率明显高于非胃切除患者（P=0.005）。此外，不同年龄、性别和手术适应证的残胃患者中，对 5 种抗生素的耐药性均无明显变化。
胃部分切除术后患者幽门螺杆菌感染的流行率较低。残胃患者更易携带甲硝唑耐药的幽门螺杆菌菌株。
