药敏试验对临床幽门螺杆菌菌株根治的指导意义

The role of Drug Susceptibility Testing in Helicobacter Pylori(HP)Eradication Therapy

目的探讨幽门螺杆菌(Helicobacterpylori,HP)对常用抗生素耐药特点,为临床选用抗生素治疗HP提供依据。方法采用改良Kibybauer法对53例HP分离菌株进行阿莫西林、甲硝唑、克拉霉素、庆大霉素、氟嗪酸、痢特灵药敏试验。分析其特点,并将体外药敏试验结果与体内治疗效果相比较。结果①阿莫西林与克拉霉素、甲硝唑与庆大霉素组间差别无统计学意义(P>0.05),其余各组间差别均有统计学意义(P<0.05,P<0.01);②阿莫西林耐药菌株对庆大霉素和痢特灵显著敏感(P<0.005)、克拉霉素敏感(P<0.025);甲硝唑耐药菌株对阿莫西林、庆大霉素、痢特灵显著敏感(P<0.005)、克拉霉素敏感(P<0.025);庆大霉素耐药菌株对阿莫西林、甲硝唑、痢特灵显著敏感(P<0.005)、克拉霉素敏感(P<0.025);③高敏根除率为100%(5/5),中、低敏根除率为75%(6/8),耐药根除率为25%(1/4)。结论药敏试验对临床幽门螺杆菌菌株的根治有指导作用。

Objective:To study the character of HP risistance to antimicrobial agents,and to provide clinical evidence of choosing agents.Methods:Using Kirby-Bauer disk diffusion test improved to observe antimicrobial susceptibility of 53 HP strains to Amoxicilin,Metronidazole,Clarithromycin,Gentamicin,and Norfroxacin,and made a comparison between in vitro and in vivo.Results:HP strains had resistance to some commonly used eradication agents.The Results of antimicrobial sensitivity testing and therapy in vivo showed the same results.Conclusion:Drug susceptibility testing can direct HP eradication therapy.