药物治疗幽门螺旋杆菌及其多药耐药性的研究现状及发展趋势

Research Status and Development Trend of Drug Therapy for Helicobacter Pylori and Its Multidrug Resistance

幽门螺旋杆菌(Helicobacter pylori,Hp)的耐药性在全球范围内呈上升趋势,而多药耐药严重阻碍了这一多发慢性感染的成功根除。本文主要讨论了幽门螺旋杆菌的多药耐药性,概述了目前对抗多药耐药的方法和未来的发展方向。与多药耐药相关的因素包括抗生素滥用、治疗失败、基因突变、外排泵和生物膜等相关因素。解决多药耐药情况不断增加的重要方向主要是,优化现有根除方案及开发新的根除方案,更广泛地使用含铋方案,发现并评估新的抗生素,如较新的喹诺酮类药物等,发挥益生菌的辅助作用,以及疫苗和非侵入性测试的研发。然而,现在还需要更多的努力和研究,菌株药物敏感性检测也变得越来越重要。

The drug resistance of Helicobacter pylori(Helicobacter pylori, Hp) is on the rise worldwide, and multidrug resistance seriously hinders the success of eradication of this multiple chronic infection. This paper mainly discusses the rate of multidrug resistance of Helicobacter pylori, and summarizes the current methods of combating multidrug resistance and the direction of development in the future. Factors related to multidrug resistance include abuse of antibiotics, treatment failure, gene mutation, efflux pump, biofilm and other related factors. An important direction to address the increasing multidrug resistance could generally be the optimization of existing eradication schemes and the development of new eradication schemes, the wider use of bismuth-containing regimens, the detection and evaluation of new antibiotics, such as newer quinolones, or the complementary role of probiotics, and the development of vaccines and non-invasive tests. However, more efforts and research are needed, and strain sensitivity detection is becoming more and more important.