Ringerike Hospital, Vestre Viken Health trust, Hønefoss, Norway.
Research Group Gastroenterology and Nutrition, Department of Clinical Medicine, UiT the Artic University, Tromsø, Norway.
PLoS One. 2022 Apr 20;17(4):e0265322. doi: 10.1371/journal.pone.0265322. eCollection 2022.
Increasing prevalence of antibiotic resistance especially to clarithromycin and metronidazole has been observed in Helicobacter pylori (H. pylori).
To characterize the antimicrobial resistance pattern of H. pylori before and after treatment in a cohort of patients accumulated over a period of 15 years after an unsuccessful eradication treatment had been given comparing sensitivity data from patients with newly diagnosed H. pylori infection. A specific objective was to look for resistance to levofloxacin.
Total of 50 patients newly diagnosed for H. pylori infection treated with omeprazole and amoxicillin/clarithromycin and 42 H pylori treatment-resistant patients treated with omeprazole and amoxicillin/levofloxacin were enrolled in this study. Cultures including antibiotic sensitivity testing were conducted according to standard laboratory routines and thus also in keeping with a European study protocol using E-test gradient strips or disc diffusion methods.
Clarithromycin resistance was more frequently observed in the H. pylori resistant group than in newly diagnosed H. pylori group (39% versus 11%). Regarding metronidazole the distribution was 70% versus 38%, and 8% versus 12% were resistant to tetracycline. No resistance was observed for amoxicillin. After re-treatment of patients belonging to the H. pylori treatment-resistant group, just two patient strains were recovered of which one harbored metronidazole resistance. In the group of newly diagnosed H. pylori, seven patients were culture positive by control after treatment. Two and three patient strains showing resistance to clarithromycin and metronidazole, respectively. None of the strains in our material was classified as resistant to amoxicillin and levofloxacin. Whereas 12% was resistant to tetracycline in the newly diagnosed before treatment.
Clarithromycin resistance was more frequent in the H. pylori treatment-resistant group than strains from patients with newly diagnosed H. pylori infection. No resistance was observed to amoxicillin and levofloxacin. In such cases Therefore levofloxacin may be used provided in vitro sensitivity testing confirms applicability.
ClinicalTrials.gov identifier: NCT05019586.
幽门螺杆菌（H. pylori）对抗生素的耐药性（尤其是克拉霉素和甲硝唑）日益普遍。
在经历了一次根除治疗失败后，对一组患者进行了为期 15 年的随访，以确定 H. pylori 在治疗前后的耐药模式，并与新诊断的 H. pylori 感染患者的药敏数据进行比较。具体目标是寻找对左氧氟沙星的耐药性。
本研究共纳入 50 例新诊断为 H. pylori 感染的患者，接受奥美拉唑和阿莫西林/克拉霉素治疗；42 例 H. pylori 治疗耐药患者，接受奥美拉唑和阿莫西林/左氧氟沙星治疗。根据标准实验室程序进行培养，包括抗生素敏感性检测，同时还根据欧洲研究方案使用 E 试验梯度条或纸片扩散法进行。
在 H. pylori 耐药组中，克拉霉素耐药的发生率高于新诊断的 H. pylori 组（39%比 11%）。甲硝唑的分布情况分别为 70%和 38%，8%和 12%的菌株对四环素耐药。阿莫西林未发现耐药。在 H. pylori 治疗耐药组患者进行再治疗后，仅回收了两株患者菌株，其中一株携带甲硝唑耐药性。在新诊断的 H. pylori 组中，7 例患者在治疗后通过对照培养阳性。分别有两株和三株患者菌株对克拉霉素和甲硝唑耐药。我们的材料中没有菌株被归类为对阿莫西林和左氧氟沙星耐药。而在新诊断的患者中，未经治疗前 12%对四环素耐药。
在 H. pylori 治疗耐药组中，克拉霉素耐药的发生率高于新诊断的 H. pylori 感染患者。对阿莫西林和左氧氟沙星未发现耐药。在这种情况下，如果体外药敏试验证实适用，可使用左氧氟沙星。
ClinicalTrials.gov 标识符：NCT05019586。
