Lab of Microbiology, Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
Lab of Microbiology, Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China; Nosocomial Infection Control Department, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
Int J Med Microbiol. 2024 Jun;315:151622. doi: 10.1016/j.ijmm.2024.151622. Epub 2024 May 21.
The increasing prevalence of antibiotic-resistant Helicobacter pylori strains poses a significant threat to children's health. This study investigated antibiotic resistance rates in Helicobacter pylori strains isolated from children in Shanghai and analyzed the presence of virulence genes in these strains.
We obtained 201 Helicobacter pylori strains from pediatric patients with upper gastrointestinal symptoms who underwent gastrointestinal endoscopy between 2019 and 2022. Subsequently, we performed antibiotic susceptibility tests and virulence gene PCR assays on these strains.
Helicobacter pylori resistance rates of 45.8%, 15.4%, 1.0%, and 2.5% were detected for metronidazole, clarithromycin, amoxicillin, and levofloxacin, respectively. Among all isolates, 64.7% exhibited resistance to at least one antibiotic. Resistance to metronidazole and clarithromycin increased from 2019 to 2022. The predominant vacA gene subtype was vacA s1a/m2. The prevalence of vacA m2 and dupA exhibited an upward trend, while oipA presented a decreasing trend from 2019 to 2022. The prevalence of dupA was significantly higher in gastritis than peptic ulcer disease, and in non-treatment compared to treatment groups.
Helicobacter pylori antibiotic resistance remains high in children and has risen in recent years. Therefore, the increasing use of metronidazole and clarithromycin requires increased monitoring in children. No association was observed between antibiotic resistance and virulence gene phenotypes.
抗生素耐药的幽门螺杆菌菌株的流行率不断增加，对儿童健康构成了重大威胁。本研究调查了上海儿童分离的幽门螺杆菌菌株的抗生素耐药率，并分析了这些菌株中毒力基因的存在情况。
我们从 2019 年至 2022 年间接受胃肠内镜检查的患有上消化道症状的儿科患者中获得了 201 株幽门螺杆菌菌株。随后，我们对这些菌株进行了抗生素药敏试验和毒力基因 PCR 检测。
我们检测到幽门螺杆菌对甲硝唑、克拉霉素、阿莫西林和左氧氟沙星的耐药率分别为 45.8%、15.4%、1.0%和 2.5%。在所有分离株中，有 64.7%至少对一种抗生素耐药。2019 年至 2022 年，甲硝唑和克拉霉素的耐药率均有所增加。主要的 vacA 基因亚型为 vacA s1a/m2。vacA m2 和 dupA 的流行率呈上升趋势，而 oipA 的流行率则呈下降趋势。2019 年至 2022 年，dupA 在胃炎中的流行率明显高于消化性溃疡病，在未治疗组中明显高于治疗组。
儿童幽门螺杆菌的抗生素耐药率仍然很高，并且近年来呈上升趋势。因此，甲硝唑和克拉霉素的使用增加需要在儿童中加强监测。抗生素耐药性与毒力基因表型之间未观察到相关性。
