不同抗生素耐药水平下幽门螺杆菌对黄连素的耐药特性

Resistance of Helicobacter pylori to Berberine in Different Antibiotic Resistance Levels

目的探究台州市温岭地区幽门螺杆菌(H.pylori)对黄连素的耐药情况,为H.pylori根除治疗的临床用药提供指导.方法采用琼脂稀释法对84例H.pylori菌株进行抗生素药敏实验,检测6种抗生素(克拉霉素、左氧氟沙星、甲硝唑、阿莫西林、四环素、黄连素)对H.pylori菌株的最低抑制浓度(MIC).结果84例H.pylori菌株对克拉霉素、左氧氟沙星、甲硝唑的耐药率分别为16.67%、16.67%、54.76%,对阿莫西林及四环素均敏感.H.pylori菌株对各种抗生素及不同浓度黄连素的耐药率在性别间比较差异均无统计学意义(P>0.05).菌株黄连素的耐药性与甲硝唑呈正相关(P<0.05).随着菌株对其他抗生素耐药性增强,其对黄连素的耐药性有增强趋势.其中,黄连素对抗生素全敏感菌株的MIC和对单耐药、双耐药及3种抗生素耐药菌株的MIC比较差异有统计学意义(P<0.05).结论对于抗生素耐药率低的H.pylori,黄连素在较低浓度下对H.pylori具有一定的抑制或杀灭的作用,且随着浓度增大,杀菌效果越好,这为制定黄连素参与的H.pylori治疗方案提供了科学依据.

Objective To investigate the resistance of H.pylori to berberine in the Wenling area of Taizhou and provide guidance for the clinical use of H.pylori eradication therapy.Methods Antimicrobial susceptibility testing was performed on 84 H.pylori strains by agar dilution method.The minimum inhibitory concentration(MIC)of four antibiotics(clarithromycin,levofloxacin,metronidazole,amoxicillin,tetracycline,berberine)against H.pyloristrains was detected.Results The resistance rates of 84 H.pylori strains to clarithromycin,levofloxacin and metronidazole were 16.67%,16.67% and 54.76%,respectively.And all H.pylori strains sensitive to both amoxicillin and tetracycline.The resistance rates of H.pylori strains to various antibiotics and different concentrations of berberine were not statistically different between genders(P>0.05).The resistance of the strain berberine was positively correlated with metronidazole(P<0.05).As the strains have increased resistance to other antibiotics,their resistance to berberine has increased.The MIC of berberine on antibiotic-sensitive strains and the MIC of single-drug resistant,double-resistant and three antibiotic-resistant strains were statistically different(P<0.05).Conclusion For H.pylori with a low antibiotic resistance rate,Berberine has a certain inhibitory or killing effect on H.pylori at lower concentrations.And as the concentration increases,the better the sterilization effect,which provides a scientific basis for the development of H.pylori treatment programs.