山西省243株幽门螺杆菌药物敏感性及克拉霉素耐药基因突变特征分析

Analysis on drug resistance of 243 Helicobacter pylori isolates from Shanxi Province,China and its mutations characteristics of 23SrRNA

目的了解山西幽门螺杆菌(Helicobacter pylori,H.pylori)对5种抗生素药物敏感性及其克拉霉素耐药相关基因突变特征。方法收集临床分离的H.pylori243株,采用纸片扩散法检测H.pylori对5种抗菌药物的敏感性。选取所有耐克拉霉素及相当数量的敏感菌株,提取基因组DNA,PCR法扩增23SrRNA基因功能区并测序,测序结果采用DNAStar软件包分析。统计结果分析采用χ2检验和Fisher精确概率法。结果临床分离的243株H.pylori,药敏结果显示对甲硝唑,克拉霉素,阿莫西林,左氧氟沙星和呋喃唑酮5种药物的耐药率分别为:75.3%(183/243),7.4%(18/243),7.4%(18/243),12.4%(30/243),8.6%(21/243),5种药物的耐药率有统计学意义(P<0.05)。结论 H.pylori临床菌株对甲硝唑,左氧氟沙星,克拉霉素、阿莫西林及呋喃唑酮存在不同程度的耐药,以对甲硝唑耐药率最高。克拉霉素耐药菌株23SrRNA基因突变以A2143C为主,此突变可能与该地区H.pylori耐药性有关,此外,还发现了A2214G位点的突变。

Antimicrobial resistance of Helicobacter pylori isolated from Shanxi and the mutations characteristics of 23SrRNA were analyzed.A total of 243 H.pylori strains were tested for their antimicrobial resistance to metronidazole,clarithromycin,amoxicillin,levofloxacin,and furazolidone by Disk diffusion test,and the segment of 23SrRNA of 37 strains （18strains resistant to clarithromycin,18 strains susceptible to clarithromycin and NCTC11637） were amplified by PCR.The amplified products were sequenced,and the results were analyzed by DNAStar software package.The rate of H.pylori resistance to metronidazole,clarithromycin,amoxicillin,levofloxacin,and furazolidone were 75.3% （183/243）,7.4% （18/243）,7.4%（18/243）,12.4 % （30/243）and 8.6 % （21/243）,respectively.Chi-square test showed the rates of resistance to the 5 drugs were significantly different（P〈0.05）.The results showed the rate of resistant isolates in Shanxi to metronidazole was the highest;the mutations A2143C and A2214G were found in clarithromycin-resistant isolates from this province.The former is probably associated with resistance to clarithromycin and the later has not been reported in other areas.