Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Department of Blood Transfusion, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Front Cell Infect Microbiol. 2022 Feb 4;11:819506. doi: 10.3389/fcimb.2021.819506. eCollection 2021.
Antimicrobial susceptibility testing (AST) plays a vital role in anti- treatment, but the traditional AST method has difficulty detecting heteroresistance, which may cause an increased prevalence of resistant strains and eradication failure.
To investigate the characteristics of heteroresistance in in gastric biopsies and investigate its clinical relevance.
A total of 704 gastric biopsies were selected for 23S rRNA and gyrA gene sequencing, 470 isolates from these biopsies were selected for AST, and the clinical characteristics of the patients were reviewed.
For the 699 biopsies that were positive for 23S rRNA gene, 98 (14.0%) showed a heteroresistance genotype, and a wild type (WT) combined with A2143G (86.7%) genotype was found in most samples. For the 694 biopsies that were positive for gyrA gene, 99 (14.3%) showed a heteroresistance genotype, and a WT combined with 87K (26.3%) or WT combined with 91N (23.2%) genotype was predominant. According to the E-test results, the resistance rates of heteroresistance genotype samples for clarithromycin and levofloxacin were 36.2% and 68.1%, respectively. When dividing the heteroresistance samples into different groups according to the sequencing profile peaks of the mutation position, the resistance rates were higher along with mutation peaks at the mutation position. In addition, patients infected with mutated or heteroresistant strains showed lower peptic ulcer detection rates than those infected with the WT strain (p < 0.05).
Heteroresistance genotypes for clarithromycin and levofloxacin were not rare in . Most cases with a heteroresistance genotype showed a susceptible phenotype for clarithromycin and a resistance phenotype for levofloxacin. Patients infected with heteroresistance genotype strains showed a lower peptic ulcer detection rate than those infected with the WT strain.
抗菌药物敏感性测试（AST）在抗感染治疗中起着至关重要的作用，但传统的 AST 方法难以检测异质性耐药性，这可能导致耐药菌株的流行增加和治疗失败。
研究胃活检中 的异质性耐药特征，并探讨其临床相关性。
共选取 704 例胃活检组织进行 23S rRNA 和 gyrA 基因测序，从这些活检组织中选取 470 株进行 AST，并回顾性分析患者的临床特征。
在 699 例 23S rRNA 基因阳性的活检组织中，98 例（14.0%）显示异质性耐药基因型，大多数样本中发现野生型（WT）与 A2143G（86.7%）基因型结合。在 694 例 gyrA 基因阳性的活检组织中，99 例（14.3%）显示异质性耐药基因型，WT 与 87K（26.3%）或 WT 与 91N（23.2%）基因型结合占优势。根据 E 试验结果，异质性耐药基因型样本对克拉霉素和左氧氟沙星的耐药率分别为 36.2%和 68.1%。根据突变位置测序谱峰将异质性耐药样本分为不同组时，耐药率随着突变位置的突变峰而升高。此外，与 WT 菌株相比，感染突变或异质性耐药株的患者消化性溃疡检出率较低（p<0.05）。
在 中，克拉霉素和左氧氟沙星的异质性耐药基因型并不罕见。大多数异质性耐药基因型病例对克拉霉素表现为敏感表型，对左氧氟沙星表现为耐药表型。感染异质性耐药基因型菌株的患者消化性溃疡检出率低于 WT 菌株感染患者。
Zotero 插件