石家庄地区幽门螺杆菌临床分离株耐药性分析

Analysis on drug resistance of Helicobacter pylori clinical isolates in Shijiazhuang area

目的了解石家庄地区幽门螺杆菌(Helicobacter pylori,H.pylori)临床分离株对多种抗生素的耐药状况,为选择有效的H.pylori根除方案提供临床指导。方法收集200例H.pylori感染的患者,对其胃黏膜活检组织进行H.pylori分离培养,采用Kirby-Bauer法检测H.pylori临床分离株对甲硝唑、克拉霉素、阿莫西林、左氧氟沙星、呋喃唑酮、四环素等6种抗生素的耐药率。结果从200例患者中分离出121株H.pylori,阳性率60.5%,不同性别、年龄的培养阳性率差异无统计学意义(P>0.05);H.pylori对甲硝唑、克拉霉素、阿莫西林、左氧氟沙星、呋喃唑酮和四环素的耐药率分别为95.0%(115/121)、26.4%(32/121)、2.5%(3/121)、5.8%(7/121)、0和3.3%(4/121)。不同性别、年龄的耐药率差异无统计学意义(P>0.05)。结论石家庄地区H.pylori对甲硝唑、克拉霉素的耐药率较高,这些药物不宜作为治疗H.pylori的一线药物;阿莫西林、左氧氟沙星、呋喃唑酮和四环素的耐药率较低,可作为治疗H.pylori感染的主要药物。

Objective To know about the antibiotic resistance of Helicobacter pylori（H.pylori）clinical isolates in Shijiazhuang area and to provide the clinical guidelines for choosing effective agents for H.pylori eradication therapy.Methods Gastric mucosa tissues of 200patients with H.pylori infections were collected to isolate and identify H.pylori.Kirby-Bauer test was performed to test the susceptibility of H.pylori clinical isolates to metronidazole,clarithromycin,amoxicillin,levofloxacin,furanzolidone and tetracycline.Results A total of 121H.pylori strains were isolated from 200samples（60.5%）and there were no statistical significance in the isolation rate between the patients with different gender and age（P〉 0.05）.The resistance rate of H.pylori to metronidazole,clarithromycin,amoxicillin,levofloxacin,furanzolidone and tetracycline was respectively 95.0%（115/121）,26.4%（32/121）,2.5%（3/121）,5.8%（7/121）,0and 3.3%（4/121）.There were no statistical significance between different gender and age（P〉 0.05）.Conclusion In Shijiazhuang area,the resistance rate of H.pylori to metronidazole and clarithromycin is higher,the medicines should not be used as first-line agents for H.pylori treatment.The resistance rate of H.pylori to amoxicillin,levofloxacin,furanzolidone and tetracycline is lower,and these medicines can be used as major agents for H.pylori treatment.