Alvarez-Aldana Adalucy, Fernandez Uribe Paula Andrea, Mejía Valencia Tatiana, Guaca-Gonzalez Yina Marcela, Santacruz-Ibarra Jorge Javier, Arturo-Arias Brenda Lucia, Castañeda-Chavez Luis Javier, Pacheco-López Robinson, Londoño-Giraldo Lina María, Moncayo-Ortiz José Ignacio
Grupo de Investigación en Microbiología y Biotecnología (MICROBIOTEC), Universidad Libre Seccional Pereira, Pereira, Colombia.
Grupo de Investigación ESCULAPIO, Universidad Libre Seccional Cali, Cali, Colombia.
Microbiol Spectr. 2024 Aug 6;12(8):e0040124. doi: 10.1128/spectrum.00401-24. Epub 2024 Jun 25.
The aim of the present study was first to isolate from gastric biopsy specimens and to test their antibiotic susceptibility. Second, it was to evaluate the efficacy of the standard triple therapy from patients of the west central region of Colombia. positive patients received standard triple therapy with proton pump inhibitor (PPI) (40 mg b.i.d.), clarithromycin (500 mg b.i.d.), and amoxicillin (1 g b.i.d.) for 14 days. Thereafter, antibiotic susceptibility of the isolates was assessed by E-Test. From 94 patients enrolled, 67 were positive for by histology or culture. Overall resistance to metronidazole, levofloxacin, rifampicin, clarithromycin, and amoxicillin was 81%, 26.2%, 23.9%, 19%, and 9.5%, respectively. No resistance was found for tetracycline. A total of 54 patients received standard triple therapy, 48 attended follow-ups testing, and of them, 30 had resistance test reports. Overall eradication rate was 81.2%. Second-line treatment was given to eight patients, four of whom were followed up with a 13C urea breath test (UBT) and remained positive for . Eradication was significantly higher in patients with clarithromycin susceptible than in resistant strains (95.6% vs 42.8% = 0.001). The updated percentages of resistance to clarithromycin in this geographical area had increased, so this value must be considered when choosing the treatment regimen.IMPORTANCEAntibiotic resistance in has increased worldwide, as has resistance to multiple antimicrobials (MDRs), which seriously hampers the successful eradication of the infection. The ideal success rate in eradicating infection (≥90%) was not achieved in this study (81.2%). This is the first time that MDR is reported (14.3%) in the region; the resistance to clarithromycin increased over time (3.8%-19%), and levofloxacin (26.2%) and rifampicin (23%) resistant isolates were detected for the first time. With these results, strain susceptibility testing is increasingly important, and the selection of treatment regimen should be based on local antibiotic resistance patterns.
本研究的目的首先是从胃活检标本中分离出[具体病菌名称未给出]并检测其抗生素敏感性。其次，是评估哥伦比亚中西部地区患者接受标准三联疗法的疗效。阳性患者接受质子泵抑制剂（PPI）（40毫克，每日两次）、克拉霉素（500毫克，每日两次）和阿莫西林（1克，每日两次）的标准三联疗法，疗程为14天。此后，通过E-Test评估分离株的抗生素敏感性。在纳入的94例患者中，67例经组织学或培养检测为[具体病菌名称未给出]阳性。对甲硝唑、左氧氟沙星、利福平、克拉霉素和阿莫西林的总体耐药率分别为81%、26.2%、23.9%、19%和9.5%。未发现对四环素耐药的情况。共有54例患者接受了标准三联疗法，48例接受了随访检测，其中30例有耐药性检测报告。总体根除率为81.2%。8例患者接受了二线治疗，其中4例接受了13C尿素呼气试验（UBT）随访且仍为[具体病菌名称未给出]阳性。克拉霉素敏感患者的根除率显著高于耐药菌株患者（95.6%对42.8%，P = 0.001）。该地理区域对克拉霉素的耐药率更新后有所上升，因此在选择治疗方案时必须考虑这一数值。
重要性
全球范围内，[具体病菌名称未给出]的抗生素耐药性以及对多种抗菌药物（多重耐药菌，MDRs）的耐药性均有所增加，这严重阻碍了感染的成功根除。本研究未达到根除[具体病菌名称未给出]感染的理想成功率（≥90%）（81.2%）。这是该地区首次报告多重耐药菌（14.3%）；对克拉霉素的耐药性随时间增加（3.8%-19%），并且首次检测到对左氧氟沙星（26.2%）和利福平（23%）耐药的分离株。基于这些结果，菌株敏感性检测变得越来越重要，治疗方案的选择应基于当地的抗生素耐药模式。
