深圳市幽门螺杆菌耐药特点多中心研究

A multicenter study of antibiotic resistance characteristics of Helicobacter pylori in Shenzhen

目的分析深圳市幽门螺杆菌(Helicobacter pylori,H.pylori)抗生素耐药特点,以及药敏结果指导下H.pylori根治率情况。方法深圳多中心2017年1月至2018年12月募集碳13尿素呼气试验(13C urea breath test,13C-UBT)阳性初治、胃镜检查患者,行H.pylori培养及药敏试验分析耐药特点,并依据药敏结果根治H.pylori,分析药敏结果及耐药背景指导下H.pylori根治率。结果2017年1月至2018年12月共完成H.pylori培养688例,培养阳性率76.9%,药敏试验结果显示抗生素耐药率分别为阿莫西林1.3%,克拉霉素34.0%,左氧氟沙星40.5%,甲硝唑90.4%,痢特灵、盐酸四环素暂未见耐药,联合耐药率56.1%。培养阳性患者依据药敏结果根治率达94.4%,培养阴性患者依据耐药背景根治率为85.4%。结论深圳地区H.pylori联合耐药率已高于55%。阿莫西林、呋喃唑酮、四环素耐药率低,克拉霉素、左氧氟沙星耐药率较高,且左氧氟沙星耐药率已高于克拉霉素。依据药敏结果及本地抗生素耐药背景,可有效提高H.pylori根治率。

Objective To analyze the antibiotic resistance characteristics of Helicobacter pylori(H.pylori)in Shenzhen,and the eradication rate of it based on the results of antibiotic resistance.Methods Patients undergoing gastroscopy with initial treatment of 13C urea breath test(13C-UBT)positive in Shenzhen from January 2017 to December 2018 were collected.H.pylori culture and antimicrobial susceptibility testing were carried out to analyze the antibiotic resistance characteristics.H.pylori was cured according to the drug susceptibility.The eradication rate of H.pylori based on the antimicrobial susceptibility testing and resistance background was analyzed.Results A total of 688 H.pylori cultures were completed from January 2017 to December 2018,and the positive rate of culture was 76.9%.The antimicrobial susceptibility testing showed the antibiotic resistance rates:1.3%for amoxicillin,34.0%for clarithromycin,40.5%for levofloxacin,and 90.4%for metronidazole.No resistance was observed for furazolidone and tetracycline hydrochloride.The resistance rate for multiple antibiotics was 56.1%.The eradication rate of patients with positive culture was 94.4%based on the results of antimicrobial susceptibility testing,and that of patients with negative culture was 85.4%according to the resistance background.Conclusion Shenzhen sees that the multiple antibiotics resistance rate for H.pylori was higher than 55%.The resistance rate of amoxicillin,furazolidone and tetracycline was low,and that of clarithromycin and levofloxacin was relatively higher.And levofloxacin had a higher resistance rate than clarithromycin.The eradication rate for H.pylori could be improved according to the results of antimicrobial susceptibility testing and the local antibiotic resistance background.