幽门螺杆菌培养阳性率及抗菌药物敏感性谱（加拿大温哥华）

Helicobacter pylori culture positivity and antimicrobial susceptibility profiles (Vancouver, Canada).

作者信息

Hamze Hasan, Payne Michael, Stefanovic Aleksandra, Lowe Christopher F, Romney Marc G, Matic Nancy

机构信息

Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, Bc V6T 1Z7, Canada.

Department of Pathology and Laboratory Medicine, St. Paul's Hospital, Providence Health Care, 1081 Burrard St., Vancouver, Bc V6Z 1Y6, Canada.

出版信息

J Antimicrob Chemother. 2025 Jun 3;80(6):1640-1646. doi: 10.1093/jac/dkaf114.

DOI:10.1093/jac/dkaf114

PMID:40202867

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12129581/

Abstract

INTRODUCTION

Helicobacter pylori is associated with gastrointestinal diseases including gastritis and peptic ulcers. Despite its significance, there is a scarcity of antimicrobial susceptibility testing (AST) data available for this organism in North America.

OBJECTIVES

The aim of this study was to assess the AST profile and identify factors associated with H. pylori culture positivity in a cohort of patients with refractory H. pylori undergoing gastric biopsies.

METHODS

We retrospectively reviewed gastric biopsy specimens received for culture between July 2009 and February 2023. We analyzed specimen transport time, Gram smear results, direct urease test findings, culture positivity and AST profiles. Using gradient strip methodology and European Committee on Antimicrobial Susceptibility Testing breakpoints, AST was conducted for amoxicillin, clarithromycin, metronidazole, levofloxacin and tetracycline.

RESULTS

Of 579 biopsy samples received for H. pylori culture, 228 (39.4%) tested positive. Samples transported within <1 h had significantly higher odds (1.81 times, P < 0.015) of being culture positive compared to those with longer transport times. Smear-positive samples had substantially higher odds (18.8 times, P < 0.001) of culture positivity compared to smear-negative. Urease-positive samples demonstrated notably higher odds (7.7 times, P < 0.001) of culture positivity compared to urease-negative samples. The collection of isolates from gastric biopsies showed susceptibility rates of 97.3% to amoxicillin, 99.1% to tetracycline, 50.4% to levofloxacin, 25.9% to metronidazole and 12.9% to clarithromycin.

CONCLUSIONS

Short sample transport time was associated with improved H. pylori recovery rates. In this cohort of refractory H. pylori cases, susceptibility rates were high for amoxicillin and tetracycline and low for clarithromycin, metronidazole and levofloxacin. Susceptibility rates remained stable over time.

摘要

引言

幽门螺杆菌与包括胃炎和消化性溃疡在内的胃肠道疾病相关。尽管其具有重要意义，但在北美，关于该菌的抗菌药物敏感性试验（AST）数据却很匮乏。

目的

本研究旨在评估难治性幽门螺杆菌患者队列中行胃活检时的AST情况，并确定与幽门螺杆菌培养阳性相关的因素。

方法

我们回顾性分析了2009年7月至2023年2月期间接受培养的胃活检标本。我们分析了标本运输时间、革兰氏涂片结果、直接尿素酶试验结果、培养阳性率和AST情况。采用梯度条带法和欧洲抗菌药物敏感性试验委员会制定的断点，对阿莫西林、克拉霉素、甲硝唑、左氧氟沙星和四环素进行AST检测。

结果

在579份接受幽门螺杆菌培养的活检样本中，228份（39.4%）检测为阳性。与运输时间较长的样本相比，运输时间<1小时的样本培养阳性的几率显著更高（1.81倍，P<0.015）。涂片阳性样本培养阳性的几率比涂片阴性样本高得多（18.8倍，P<0.001）。尿素酶阳性样本培养阳性的几率比尿素酶阴性样本显著更高（7.7倍，P<0.001）。胃活检分离株的药敏率显示，对阿莫西林为97.3%，对四环素为99.1%，对左氧氟沙星为50.4%，对甲硝唑为25.9%，对克拉霉素为12.9%。