东莞地区幽门螺杆菌感染儿童的抗生素耐药基因突变现状调查

Investigation on the Mutation of Antibiotic Resistance Gene in Children Infected by Helicobacter Pylori in Dongguan Area

目的:调查东莞地区幽门螺杆菌感染儿童的克拉霉素、甲硝唑、阿莫西林基因突变情况。方法:选取东莞市妇幼保健院(以下简称"本院")2019年12月-2021年1月确诊H.pylori感染患儿84例,经PCR扩增试剂测定H.pylori分离菌株对克拉霉素、甲硝唑及阿莫西林的耐药情况,并分析不同性别的抗生素耐药性差异。结果:抗生素耐药率为60.5%,其中克拉霉素、甲硝唑、阿莫西林及双重耐药基因突变率分别为38.2%、7.9%、9.2%、5.3%,以克拉霉素耐药基因突变率最高(P<0.05),甲硝唑及阿莫西林耐药基因突变率相近。男、女患儿克拉霉素、甲硝唑及阿莫西林耐药基因突变率比较,差异无统计学意义(P>0.05)。结论:东莞地区H.pylori感染患儿以克拉霉素耐药基因突变率最高,可能影响H.pylori感染的治疗,且在后续治疗中应充分考虑双重耐药的因素。

Objective:To investigate the gene mutations of Clarithromycin,Metronidazole and Amoxicillin in children infected with Helicobacter pylori in Dongguan.Method:A total of 84 children diagnosed with H.pylori infection from Dongguan City Maternal&Child Health Hospital from December 2019 to January 2021 were selected.The resistance of isolated H.pylori strains to Clarithromycin,Metronidazole and Amoxicillin was determined by PCR amplification reagents,and the differences in antibiotic resistance of different sexes were analyzed.Result:The antibiotic resistance rate was 60.5%.The mutation rates of Clarithromycin,Metronidazole,Amoxicillin and dual resistance genes were 38.2%,7.9%,9.2%,and 5.3%,respectively.The mutation rate of the Clarithromycin resistance gene was the highest(P<0.05),and the mutation rates of Metronidazole and Amoxicillin resistance genes were similar.There was no significant difference in the mutation rates of Clarithromycin,Metronidazole and Amoxicillin resistance genes between male and female children(P>0.05).Conclusion:The mutation rate of Clarithromycin resistance gene in children with H.pylori infection in Dongguan is the highest,which may affect the treatment of H.pylori infection,and the factors of dual resistance should be fully considered in the follow-up treatment.