幽门螺杆菌耐药性的流行病学：一所附属医院两个时期的比较——一项横断面设计。
The epidemiology of Helicobacter pylori resistance in a university affiliated hospital: a comparison between two time periods-a cross-sectional design.
机构信息
Department of Internal Medicine D, and Helicobacter Research Institute, Kaplan Medical Center, Rehovot, Israel.
Faculty of Medicine, Hebrew University, Jerusalem, Israel.
出版信息
Eur J Med Res. 2023 Nov 24;28(1):538. doi: 10.1186/s40001-023-01500-0.
PURPOSE
During the last few decades, the increased use of various types of antibiotics in the general population caused a significant change in regional Helicobacter pylori (H. pylori) antibiotic resistance. Our aim is to study the changes in H. pylori resistance in patients who had undergone an esophagogastroduodenoscopy (EGD) and susceptibility testing and found positive for H. pylori. The study was conducted in a university affiliated hospital between 2013-2020.
METHODS
A cross-sectional study was performed on all consecutive patients who had undergone an EGD and tested positive for H. pylori at the Kaplan Medical Center, Israel. The study period was divided into two sub-periods: 2013-2016 and 2017-2020. Data on age, sex, comorbidities, previous treatments, and antimicrobial susceptibility testing for six antimicrobial agents were compared.
RESULTS
The resistance rates of H. pylori to clarithromycin and dual resistance to clarithromycin and metronidazole were found significantly higher during the late period. Multivariable analysis showed that the later period, older age, and diabetes mellitus were independent predictors for antimicrobial resistance.
CONCLUSIONS
Our study has shown that there is an increasing resistance of H. pylori to clarithromycin and metronidazole while its susceptibility is unaffected with time to other antibiotics. More recent cross-sectional studies with larger samples are warranted in order to evaluate the changes in the resistance patterns of H. pylori to various antibiotics with time.
目的
在过去几十年中，由于普通人群中各种类型抗生素的使用增加，导致区域幽门螺杆菌（H. pylori）抗生素耐药性发生了重大变化。我们的目的是研究在接受食管胃十二指肠镜检查（EGD）和药敏试验且 H. pylori 阳性的患者中，H. pylori 耐药性的变化。该研究在一家大学附属医院进行，时间为 2013 年至 2020 年。
方法
对在以色列卡普兰医学中心接受 EGD 检查且 H. pylori 检测阳性的所有连续患者进行了一项横断面研究。研究期间分为两个亚期：2013-2016 年和 2017-2020 年。比较了年龄、性别、合并症、既往治疗和 6 种抗菌药物药敏试验的数据。
结果
发现晚期 H. pylori 对克拉霉素和克拉霉素与甲硝唑双重耐药的耐药率明显升高。多变量分析显示，后期、年龄较大和糖尿病是抗菌药物耐药的独立预测因素。
结论
我们的研究表明，随着时间的推移，H. pylori 对克拉霉素和甲硝唑的耐药性逐渐增加，而对其他抗生素的敏感性不受影响。需要进行更多近期的、样本量更大的横断面研究，以评估随着时间的推移，H. pylori 对各种抗生素的耐药模式的变化。
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