湖州地区651例糖尿病患者幽门螺杆菌耐药情况调查分析

Research of antibiotic resistance of Helicobacter pylori in patients with diabetes mellitus in Huzhou

目的 分析浙江省湖州地区糖尿病患者幽门螺杆菌感染及抗生素的耐药情况,为糖尿病幽门螺杆菌的根除提供理论依据。方法 选择2014年1月-2015年12月浙江省湖州市中心医院及湖州市第一人民医院就医的行胃镜检查的糖尿病患者,收集1211例胃镜下胃黏膜标本进行幽门螺杆菌分离培养,并用平板掺入法对幽门螺杆菌进行药敏试验。结果 1211例胃黏膜标本中幽门螺杆菌分离培养阳性菌株651株,阳性率为53.76%。651株幽门螺杆菌对克拉霉素、左氧氟沙星、甲硝唑的耐药率分别为25.35%、35.33%和95.70%,其他抗生素未出现耐药,其中对克拉霉素和左氧氟沙星的双重耐药率为13.21%,对克拉霉素、左氧氟沙星和甲硝唑的三重耐药率为11.37%。结论 湖州地区糖尿病患者幽门螺杆菌对克拉霉素、左氧氟沙星和甲硝唑单独抗生素均有非常高的耐药率,鉴于此情况,在根除幽门螺杆菌之前如果能够行内镜下培养将有利于幽门螺杆菌的根除。

Objective To investigate the prevalence of Helicobacter infection and antibiotic resistance in patients with diabetes mellitus in Huzhou, Zhejiang province and provide the theoretical basis for the Helicobacter pylori eradication. Methods 1211 patients of gastric mueosa biopsy specimens with diabetes mellitus in Huzhou center hospital and Huzhou first people＇s hospital from Jan 2014 to Dec 2015 were selected. Plate incorporation method was used to determine the antibiotic resistance. Results 651（53.76%） Helicohacter pylori strains were isolated from 1211 gastric mucosa biopsy specimens. The resistance rate to clarithromycin,levonoxacin, metronidazole were 25.35%, 35.33% and 95.70%,respectively. There were no Hp strains resistant to other antibiotics. The dual resistance rate to claritbromycin and levonoxaein was 13.21%, and the triple drug resistance rate to elaritbromycin, levonoxacin and metronidazole was 11.37%. Conclusion The resistance rate to clarithromycin,levonoxacin and metronidazole is very high in patients with diabetes mellitus in Huzhou. Therefore, it is important to encourage susceptibility testing to be made available locally and performed if the patient is undergoing endoscopy.