幽门螺杆菌根除失败患者耐药情况分析

An analysis of antibiotics resistance in patients with Helicobacter pylori eradication failure

目的分析幽门螺杆菌(HP)感染治疗失败患者的耐药情况,为HP感染补救治疗提供指导。方法经^(13)C呼气试验确诊HP治疗失败的门诊患者269例,行胃镜取胃窦小弯和胃体大弯黏膜标本进行培养。对HP培养阳性患者采用最低抑菌浓度试验药敏法分别行阿莫西林、克拉霉素、左氧氟沙星、甲硝唑、呋喃唑酮和四环素药敏试验。结果269例患者中,190例HP培养阳性,HP阳性率为70.63%。HP培养阳性患者中,甲硝唑耐药菌株率为97.37%,克拉霉素耐药菌株率为58.95%,左氧氟沙星耐药菌株率为48.42%,无阿莫西林、呋喃唑酮和四环素耐药菌株。二重耐药的总耐药菌株率为44.74%;其中,甲硝唑和克拉霉素耐药菌株率为47.06%,甲硝唑和左氧氟沙星耐药菌株率为47.06%,克拉霉素和左氧氟沙星耐药菌株率为5.88%。对甲硝唑、克拉霉素和左氧氟沙星三重耐药菌株率为32.11%。结论抗生素耐药是HP治疗失败的重要原因,了解耐药情况有助于选择补救治疗的个体化治疗方案,提高治疗的成功率。

Objective To analyze the antibiotics resistance in the patients with Helicobacter pylori(HP)eradication failure for providing a guidance in remedy treatment.Methods HP culture of the biopsy samples from the gastrointestinal sinus small bend and gastric body large bend mucosa taken by gastroscopy was performed in 269 patients with HP eradication failure confirmed by carbon ^(13)C-urea breath test.The minimum inhibitory concentration test was used to test the resistance of the HP positive culture samples to amoxicillin,clarithromycin,levofloxacin,metronidazole,furazolidone and tetracycline.Results Of 269 patients with HP eradication failure,190 cases were with HP positive with a positive rate of 70.63% HP infection.In 190 patients with HP positive culture,the percentages of HP line with antibiotics resistance were 97.37%for metronidazole,58.95%for clarithromycin,and 48.42%for levofloxacin.There was no case with a resistance to amoxicillin,furazolidone or tetracycline.The overall percentage of HP line with a resistance to two antibiotic drugs was 44.74%.The percentages of HP line with a resistance to two antibiotic drugs were 47.06%for metronidazole and clarithromycin,47.06%for metronidazole and levofloxacin,and 5.88%for clarithromycin and levofloxacin.The percentage of HP line with a resistance to three antibiotic drugs of metronidazole,clarithromycin and levofloxacin was 32.11%.Conclusion Antibiotic resistance is an important cause of HP treatment failure,and understanding drug resistance can help to choose individualized treatment options for remedy treatment and improve the success rate of treatment.