| 温晋锋,王伯军,丁勇,郭利华,秦丽君,叶国良,赵海敏.宁波地区幽门螺杆菌耐药谱分析及敏感抗生素的筛选[J].浙江中西医结合杂志,2018,28(6): |
| 宁波地区幽门螺杆菌耐药谱分析及敏感抗生素的筛选 |
| Analysis of Antibiotic resistance and screen sensitive antibiotics of Helicobacter pylori in Ningbo cityWen Jin-feng1, Wang Bojun1, Ding Yong1,Qin Lijun1,Guo Lihua1, Ye Guoliang1, Zhao Haimin2 |
| 投稿时间：2017-10-19 修订日期：2017-10-19 |
| DOI： |
| 中文关键词: 幽门螺杆菌 耐药 根除治疗 |
| 英文关键词:H. pylori Antibiotic resistance Eradication therapy |
| 基金项目:1、浙江省医药卫生一般研究计划(B类),根除多重耐药幽门螺杆菌三联疗法和四联疗法的筛选及其个体化疗法的比较,项目编号：2013KYB238 |
|
| 摘要点击次数: 1500 |
| 全文下载次数: 9 |
| 中文摘要: |
| 【】目的 明确宁波地区H. pylori的耐药谱,并筛选出敏感抗生素用于临床根除治疗。方法 对宁波地区2012年3月至2016年9月收集的15623例胃镜检查患者的胃粘膜组织进行H. pylori分离培养,检测H. pylori临床分离株对阿莫西林、克拉霉素、左氧氟沙星、呋喃唑酮四种常用抗生素的耐药率。并进一步对利福平、多西环素、头孢呋辛、莫西沙星、头孢他美酯、替硝唑及庆大霉素八种抗生素进行药敏检测,拟筛选出适合本地区的敏感抗生素。 结果 初次治疗患者中,H. pylori对阿莫西林、克拉霉素、左氧氟沙星、呋喃唑酮的耐药率分别为9.19%,39.81%,41.09%,22.71%,而根除治疗失败后复治患者对四种药物的耐药率分别为23.91%、53.73%、62.30%、63.07%,与初次治疗者比较耐药率均升高,差异有统计学意义。非多重耐药菌株对利福平、多西环素、头孢呋辛、莫西沙星、庆大霉素、替硝唑、头孢他美酯及阿奇霉素的耐药率为3.75%、7.75%、18.0%、37.25%、58.50%、85.75%、91.75%、78.25%；多重耐药的H. pylori相对应耐的耐药率为药率为5.95%、8.29%、22.54%、39.12%、81.53%87,01%、92.96%、95.77%。结论 宁波地区H. pylori对阿莫西林、克拉霉素、左氧氟沙星、呋喃唑酮耐药情况严重,尤其在根除治疗失败后耐药率明显升高,建议在根除治疗前进行药敏检测指导用药。目前宁波地区H. pylori对利福平、多西环素、头孢呋辛耐药率相对偏低,可在临床工作中予以推广应用。 |
| 英文摘要: |
| Aim: To observe antibiotic resistance and select sensitive antibiotics for eradication therapy of H. pylori in Ningbo city. Methods: H. pylori were isolated from gastric biopsy specimens, which were collected from 15,623 patients referred for gastro-endoscopy in Ningbo city from March 2012 to September 2016. The antibiotic resistance rate of amoxicillin, clarithromycin, levofloxacin and furazolidone was detected from isolated H. pylori strains. The susceptibility?testing?to?antibiotics of rifampicin, doxycycline, cefuroxime, moxifloxacin, cefetametester, tinidazole and gentamycin were?performed?on?all?available?H. pylori?isolates, and the sensitive antibiotics were selected for eradication therapy of H. pylori. Results: The resistance rate of initial treatment to eradicate H. pylori were 9.19% for amoxicillin, 39.81% for clarithromycin, 41.09% for levofloxacin and 22.71% for furazolidone. Whereas?if it failed to eradicate H. pylori at the first time, the antibiotic resistance proportion of above drugs were 23.91%, 53.73%, 62.30% and 63.07% respectively, and showed a significant growth in the retreatment of patients rather than initial treatment. The resistance rate of none multiple antibiotic resistant H. pylori strains?for rifampicin, doxycycline, cefuroxime, moxifloxacin, cefetametester, tinidazole and gentamycin were 3.75%, 7.75%, 18.0%, 37.25%, 58.50%, 85.75%, 91.75% and 78.25%. The resistance rate of multiple antibiotic resistant H. pylori strains?for above drugs were 5.95%, 8.29%, 22.54%, 39.12%, 81.53%, 87.01%, 92.96% and 95.77%. Conclusion: The condition of drug resistance?of H. pylori to amoxicillin, clarithromycin, levofloxacin and furazolidone in Ningbo city is severe, and the resistance rate significantly increased after eradication fails. It suggested that ?the susceptibility ?testing should be performed before eradication treatment. The antibiotics of rifampicin, doxycycline, cefuroxime may be?suitable?for?applications?to?clinical therapy because of lower resistance rate in Ningbo city. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
