López Bartolomé O, Morán Vasallo A, Ramírez Armengol J A, Picazo de la Garza J J
Servicio de Microbiología Clínica, Hospital Clínico San Carlos, Madrid.
Rev Clin Esp. 1998 Jul;198(7):420-3.
From March 1995 to February 1996 a total of 386 gastroduodenal biopsies were processed for microbiological diagnosis of Helicobacter pylori which included culture, Gram staining and urease test. For susceptibility studies to five antimicrobial agents, 35 additional gastroduodenal biopsies (n = 421) were added. There were 272 (70.4%) positive cultures, 220 (56.9%) samples with positive urase test and 244 (63.2%) with positive result in Gram-staining; both tests were statistically significant compared with culture (p < 0.05). Considering culture as the reference method, sensitivity and specificity values for the urease test were 77.0% and 92.1% and for Gram staining 86.7% and 92.9%, respectively. A total of 11 isolates were recovered from the 35 biopsies processed only for culture. Susceptibility testing of 283 isolates (272 + 11) was performed to the following antimicrobials: amoxicillin, metronidazole, clarithromycin, azythromycin and tetracycline. Resistance to metronidazole was 25.4% and the corresponding values for clarithromycin and azithromycin 9.5%. No resistance to amoxicillin or tetracycline was observed. Urease test and Gram staining are two easy-to-perform tests and when taken together allow the microbiological diagnosis of Helicobacter pylori infection. Culture should be performed to know the evolution of resistance to antimicrobials used for treatment of this infection.
1995年3月至1996年2月，共对386份胃十二指肠活检样本进行了幽门螺杆菌的微生物学诊断，检查项目包括培养、革兰氏染色和尿素酶试验。为进行对五种抗菌药物的敏感性研究，又增加了35份胃十二指肠活检样本（共421份）。培养阳性的有272份（70.4%），尿素酶试验阳性的样本有220份（56.9%），革兰氏染色阳性的有244份（63.2%）；与培养结果相比，这两项试验均具有统计学意义（p<0.05）。以培养作为参考方法，尿素酶试验的敏感性和特异性值分别为77.0%和92.1%，革兰氏染色的敏感性和特异性值分别为86.7%和92.9%。仅对35份用于培养的活检样本进行培养，共分离出11株菌株。对283株菌株（272株+11株）进行了对以下抗菌药物的敏感性试验：阿莫西林、甲硝唑、克拉霉素、阿奇霉素和四环素。对甲硝唑的耐药率为25.4%，克拉霉素和阿奇霉素的相应耐药率为9.5%。未观察到对阿莫西林或四环素的耐药情况。尿素酶试验和革兰氏染色是两项易于操作的试验，两者结合可实现幽门螺杆菌感染的微生物学诊断。应进行培养以了解用于治疗该感染的抗菌药物的耐药演变情况。
