Banatvala N, Davies G R, Abdi Y, Clements L, Rampton D S, Hardie J M, Feldman R A
Department of Epidemiology and Medical Statistics, London Hospital Medical College, QMW.
Gut. 1994 Nov;35(11):1562-6. doi: 10.1136/gut.35.11.1562.
A high prevalence of metronidazole resistance in Helicobacter pylori is reported in developing countries. This study examined whether migrants referred for diagnostic gastroscopy at a United Kingdom centre (n = 54), had a higher prevalence of metronidazole resistance than subjects born in the United Kingdom attending endoscopy (n = 46). Records of nitroimidazole treatment prescribed in the United Kingdom was obtained in 83 patients to find out if there was an association between H pylori metronidazole resistance and previous ingestion of either metronidazole or tinidazole. The prevalence of metronidazole resistant isolates varied according to country of birth: Bangladesh (90%, 27 of 30), other countries (67%, 16 of 24), and United Kingdom (37%, 17 of 46) (p < 0.001). Among those born in the United Kingdom, women were more likely to harbour resistant H pylori than men (54% v 18% respectively, p = 0.01) and more likely to have a history of previous nitroimidazole ingestion (41% v 11% respectively, p = 0.02). Patients previously exposed to either metronidazole or tinidazole were more likely to harbour resistant strains (84% (27 of 32) v 41% (21 or 51), p < 0.0001). The distribution of gastroduodenal disease, assessed endoscopically, was not affected by metronidazole resistance status.
据报道，发展中国家幽门螺杆菌对甲硝唑的耐药率很高。本研究调查了在英国一家中心接受诊断性胃镜检查的移民（n = 54），其甲硝唑耐药率是否高于在英国出生并接受内镜检查的受试者（n = 46）。获取了83例患者在英国开具的硝基咪唑治疗记录，以确定幽门螺杆菌对甲硝唑的耐药性与之前服用甲硝唑或替硝唑之间是否存在关联。甲硝唑耐药菌株的流行率因出生国家而异：孟加拉国（90%，30例中的27例）、其他国家（67%，24例中的16例）和英国（37%，46例中的17例）（p < 0.001）。在出生于英国的人中，女性比男性更有可能携带耐药幽门螺杆菌（分别为54%和18%，p = 0.01），并且更有可能有既往硝基咪唑摄入史（分别为41%和11%，p = 0.02）。既往接触过甲硝唑或替硝唑的患者更有可能携带耐药菌株（84%（32例中的27例）对41%（51例中的21例），p < 0.0001）。通过内镜评估的胃十二指肠疾病分布不受甲硝唑耐药状态的影响。
