治疗失败是幽门螺杆菌耐药性发展的关键因素。

Treatment failure is a key factor in the development of Helicobacter pylori resistance.

机构信息

Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China.

Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi Province, China.

出版信息

Helicobacter. 2024 May-Jun;29(3):e13091. doi: 10.1111/hel.13091.

DOI:10.1111/hel.13091

PMID:38780150

Abstract

BACKGROUND

Helicobacter pylori eradication failure influences its antibiotic resistance.

AIMS

This study aimed to evaluate the effect of previous treatment failures on it, including the changes in the antibiotic resistance rates, minimal inhibitory concentration (MIC) distributions, and resistance patterns.

MATERIALS AND METHODS

This single-center retrospective study included 860 primary isolates and 247 secondary isolates. Antibiotic susceptibility testing was performed for amoxicillin, metronidazole, clarithromycin, levofloxacin, furazolidone, tetracycline, and rifampicin. The demographic data and detailed regimens were collected.

RESULTS

The primary resistance rates to amoxicillin, metronidazole, clarithromycin, levofloxacin, tetracycline, rifampin, and furazolidone were 5.93%, 83.84%, 28.82%, 26.28%, 0.35%, 1.16%, and 0%, while secondary were 25.10%, 92.31%, 79.76%, 63.16%, 1.06%, 3.19%, and 0%, respectively. The resistance rates to amoxicillin, metronidazole, clarithromycin, and levofloxacin increased significantly with the number of treatment failures accumulated, and showed a linear trend. The proportion of primary and secondary multidrug-resistant (MDR) isolates were 17.79% and 63.16%, respectively. The MIC values of amoxicillin, clarithromycin, and levofloxacin were elevated significantly with medication courses increased.

CONCLUSION

The prevalence of amoxicillin, clarithromycin, levofloxacin, and metronidazole resistance would increase rapidly following first-line treatment failure, as well as the MIC values of them. Clinicians should pay great attention to the first-line treatment to cure H. pylori infection successfully.

摘要

背景

幽门螺杆菌根除失败会影响其抗生素耐药性。

目的

本研究旨在评估既往治疗失败对其的影响，包括抗生素耐药率、最小抑菌浓度（MIC）分布和耐药模式的变化。

材料和方法

这是一项单中心回顾性研究，共纳入 860 例初治分离株和 247 例再治分离株。对阿莫西林、甲硝唑、克拉霉素、左氧氟沙星、呋喃唑酮、四环素和利福平进行了抗生素敏感性测试。收集了人口统计学数据和详细的治疗方案。

结果

初治分离株对阿莫西林、甲硝唑、克拉霉素、左氧氟沙星、四环素和利福平的耐药率分别为 5.93%、83.84%、28.82%、26.28%、0.35%、1.16%和 0%，而再治分离株分别为 25.10%、92.31%、79.76%、63.16%、1.06%、3.19%和 0%。随着治疗失败次数的累积，阿莫西林、甲硝唑、克拉霉素和左氧氟沙星的耐药率显著增加，呈线性趋势。初治和再治多重耐药（MDR）分离株的比例分别为 17.79%和 63.16%。阿莫西林、克拉霉素和左氧氟沙星的 MIC 值随着用药疗程的增加而显著升高。