福建省福州地区幽门螺旋杆菌对常用抗菌药物的体外耐药情况及变化研究

Study on Resistance of Helicobacter pylori to Commonly Used Antibiotics in Vitro in Fuzhou,Fujian Province

目的研究近15年来福州地区幽门螺旋杆菌(Helicobacter pylori,Hp)对常用抗菌药物体外耐药情况及变化。方法分别收集2004~2006年及2016~2019年在福建省立医院内镜中心行胃镜检查患者的胃黏膜标本,在微需氧环境下进行Hp分离培养,并进行菌株鉴定,分别采用琼脂稀释法和微量肉汤稀释法对3种抗菌药物(阿莫西林(AMX)、克拉霉素(CLA)和甲硝唑(MET)进行体外药敏试验。结果共获得了270株分离株,2004~2006年和2016~2019年Hp对MET耐药率分别为50.00%和73.68%,P值0.015;对CLA耐药率分别为27.56%和42.10%,P值0.013;对AMX耐药率分别为1.28%和20.18%,P值<0.0001,均有统计学意义。结论近15年来福建省福州地区Hp对MET、CLA及AMX耐药率均有增加,推荐该地区患者根除Hp之前进行药敏试验。

OBJECTIVE To study the resistance of Helicobacter pylori(Hp)to commonly used antibiotics in Fuzhou city over the past 15 years.METHODS Gastric mucosa specimens were collected from the patients between 2004 to 2006 and between 2016 to 2019 in endoscopy center of Fujian Province Hospital,and Hp were cultured under the microaerobic condition.After strain identification,drug susceptibility tests to three kinds of antibiotics(amoxicillin(AMX)and clarithromycin(CLA)and metronidazole(MET)were administered using agar dilution method and broth dilution method respectively in vitro.RESULTS A total of 270 isolates were obtained.The resistance rates of Hp in 2004-2006 and 2016-2019 to MTX were 50.00%(78/156)and 73.68%(74/114),respectively,with a P value of 0.015;to CLA were 27.56%(43/156)and 42.10%(48/114),respectively,with a P value of 0.013 and to AMX were 1.28%(2/156)and 20.18%(23/114),respectively,with P<0.0001,which were all statistically significant.CONCLUSION The drug resistance rates of Hp to MET,CLA and AMX have increased in the past 15 years in Fuzhou,Fujian province.Therefore,drug resistance tests for MET,CLA and AMX are recommended before the treatment of Hp eradication in this region.