幽门螺杆菌对抗生素耐药性的多中心前瞻性分析

基础医学与临床 ›› 2020, Vol. 40 ›› Issue (12): 1661-1665.

幽门螺杆菌对抗生素耐药性的多中心前瞻性分析

叶珊珊¹, 李俊达², 周应生³, 刘璐¹, 吴建维¹, 吕志武¹, 刘锦涛^1*

1.广东医科大学宝安临床医学院深圳市宝安区人民医院消化内科, 广东深圳 518101;
2.深圳市龙华区人民医院消化内科,广东深圳 518109;
3.中国科学院大学深圳医院消化内科,广东深圳 518107

收稿日期:2020-02-03 修回日期:2020-04-25 出版日期:2020-12-05 发布日期:2020-11-30
通讯作者: ^* bill-liu118@163.com

Antibiotic resistance of Helicobacter pylori:a multicenter prospective analysis

YE Shan-shan¹, LI Jun-da², ZHOU Ying-sheng³, LIU Lu¹, WU Jian-wei¹, LYU Zhi-wu¹, LIU Jin-tao^1*

1. Department of Gastroenterology, People's Hospital of Baoan Shenzhen, Guangdong Medical University,Shenzhen 518101;
2. Department of Gastroenterology, People's Hospital of Longhua Shenzhen, Shenzhen 518109;
3. Department of Gastroenterology, Shenzhen Hospital, University of Chinese Academy of Sciences, Shenzhen 518107,China

Received:2020-02-03 Revised:2020-04-25 Online:2020-12-05 Published:2020-11-30
Contact: ^* bill-liu118@163.com

摘要/Abstract

摘要： 目的调查深圳市幽门螺杆菌(Hp)感染情况以及对常见的6种抗生素耐药情况。方法收集深圳市的3家医院共5 080例消化道不适患者胃窦黏膜组织进行Hp尿素酶快速试验和培养,并对分离菌株进行琼脂稀释法药物敏感试验。结果 5 080例患者中,Hp分离培养阳性共3 203例,阳性率为63.05%。3 203例Hp阳性患者中,Hp菌株对抗生素耐药率的高低依次为甲硝唑(MNZ)(99.6%)、阿莫西林(AMX)(30.5%)、克拉霉素(CAM)(10.6%)、多西环素(DOX)(0.3%)、呋喃唑酮(FR)(0.2%)和左氧氟沙星(LVX)(0.1%);对Hp菌株均敏感率为0.18%,单一、双重及多重耐药率分别为62.06%、33.94%和3.81%,其中,MNZ+AMX的双重耐药率最高(26.69%),MNZ+CAM +AMX的三重耐药率最高(3.68%);患者≤40岁可能是Hp菌株对抗生素单一耐药性的影响因子;患者＞40岁可能是Hp菌株对抗生素双重耐药性的影响因子;患者性别是Hp菌株对CAM以及抗生素单一、双重耐药性的影响因子。结论 Hp在该地区感染率较高且对MNZ有较高耐药性,其次是AMX和CAM。

关键词: 幽门螺杆菌, 抗生素, 耐药性

Abstract: Objective To investigate the infection of Helicobacter pylori (Hp) and its resistance to six kinds of antibiotics in Shenzhen. Methods Urease test and Hp cultivation were performed in 5 080 patients with gastrointestinal discomfort in three hospitals in Shenzhen, and antibiotic sensitivity test of agar dilution was performed. Results Among the 5 080 patients, a total of 3 203 patients were Hp positive, with a positive rate of 63.05%. The resistance rate of 3 203 Hp strains to antibiotics was metronidazole (MNZ)(99.6%),amoxicillin(AMX)(30.5%),clarithromycin(CAM)(10.6%), doxycycline (DOX) (0.3%), furazolidone(FR) (0.2%), and levofloxacin(LVX) (0.1%). The rates of total sensitivity to Hp was 0.18%, single drug resistance, double and multiple drug resistance were 62.06%, 33.94% and 3.81%, respectively. MNZ and AMX had the highest double drug resistance (26.69%), while MNZ, CAM and AMX had the highest triple drug resistance (3.68%). The age ≤40 years seems to be a factor for single antibiotic resistance, while the age ＞40 years is a risk factor for double antibiotic resistance of Hp strain. Gender is an influence factor of Hp strain on CAM and single and double antibiotic resistance. Conclusions Hp has a high infection rate and high resistance to MNZ, followed by AMX and CAM.

Key words: Helicobacter pylori, antibiotics, resistance

中图分类号:

R573

叶珊珊, 李俊达, 周应生, 刘璐, 吴建维, 吕志武, 刘锦涛. 幽门螺杆菌对抗生素耐药性的多中心前瞻性分析[J]. 基础医学与临床, 2020, 40(12): 1661-1665.

YE Shan-shan, LI Jun-da, ZHOU Ying-sheng, LIU Lu, WU Jian-wei, LYU Zhi-wu, LIU Jin-tao. Antibiotic resistance of Helicobacter pylori:a multicenter prospective analysis[J]. Basic & Clinical Medicine, 2020, 40(12): 1661-1665.

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