中国大陆地区幽门螺杆菌对常用抗生素耐药性的临床分析

Clinical analysis of the resistance of Helicobacter pylori to commonly prescribed antibiotics in Chinese mainland

目的分析近几年中国大陆地区(简称中国大陆)甲硝唑、克拉霉素、左氧氟沙星、阿莫西林、呋喃唑酮和四环素治疗幽门螺杆菌(Hp)耐药性的变化趋势和地区差异。方法通过检索多个数据库,收集中国大陆Hp对6种常用抗生素耐药性的相关文献,并用Stata15软件进行分析。回顾并比较目前河南大学淮河医院常用抗生素耐药情况。结果2013—2020年中国大陆甲硝唑耐药性最高,克拉霉素次之,阿莫西林耐药性最低。阿莫西林在南方地区的耐药性明显高于北方。甲硝唑、克拉霉素、左氧氟沙星和阿莫西林耐药性在2019—2020年达到或接近最高值。目前河南大学淮河医院阿莫西林和呋喃唑酮耐药性较低,克拉霉素最高。结论目前中国大陆Hp对常用的抗生素的耐药性均处于较高水平状态,其中对甲硝唑和克拉霉素耐药性较高,对阿莫西林耐药性较低,该状况以南方较为突出。

Objective To find the trends and regional differences of the resistance of Helicobacter pylori(Hp)to metronidazole,clarithromycin,levofloxacin,amoxicillin,furazolidone and tetracycline in recent years in the mainland of China.Methods By searching several databases,the literatures on the resistance of Hp to six commonly prescribed antibiotics in mainland of China were collected and analyzed with Stata15 software.The antibiotic resistance in Huaihe Hospital of Henan University was reviewed and compared.Results The investigation results from 2013 to 2020 showed that rate of Hp metronidazole resistance was the highest and the clarithromycin was the second,while the rate of resistance to amoxicillin was the lowest one.The amoxicillin resistance in the south of China was significantly higher than that in the north of China.The resistance to metronidazole,clarithromycin,levofloxacin and amoxicillin reached(or closed to)the highest level from 2019 to 2020.At present,the resistance to amoxicillin and furazolidone was low and the resistance to clarithromycin was the highest in Huaihe Hospital of Henan University.Conclusions The resistance of Hp to antibiotics in the mainland of China was at a relativelyhigh level.The resistance rate to metronidazole and clarithromycin was high,while that to amoxicillin was low.The antibiotic resistance of HP was more popular in the south of China.