儿童胃黏膜组织中幽门螺杆菌菌株分型及耐药性分析

Types and Drug Resistance Analysis of Helicobacter pylori Strains in Children′s Gastric Mucosa

目的探讨儿童胃黏膜中幽门螺杆菌菌株分型与病变程度及抗生素耐药的相关性。方法通过RT-PCR检测Hp阳性样本的CagA、A2142G、A2143G、rdxA基因,分析菌株分型与胃黏膜病变程度及抗生素耐药的相关性。结果检测出Hp阳性样本165例,Ⅰ型菌株117例,Ⅱ型菌株48例;克拉霉素耐药65例(39.4%),甲硝唑耐药47例(28.5%),双重耐药的有34例(20.6%),抗生素耐药的共78例(47.3%),抗生素敏感的有87例(52.7%)。Hp菌株分型与胃黏膜病变特征相关性具有统计学意义(P<0.001);克拉霉素、甲硝唑耐药、克拉霉素和或甲硝唑双重耐药与Hp分型均无相关性(均P>0.05)。结论Ⅰ型Hp感染更易致胃黏膜病变;Hp菌株基因分型与抗生素耐药不相关。

OBJECTIVE To investigate the correlation between the type of helicobacter pylori(Hp)strains in children′s gastric mucosa and the degree of lesions and antibiotic resistance.METHODS RT-PCR was applied to detect the gene level of CagA,A2142G,A2143G and rdxA in Hp-positive samples,and the correlation between strain typing and the degree of gastric mucosal lesions and antibiotic resistance was analyzed.RESULTS 165 cases of Hp-positive samples were detected,including 117 cases of type I strains and 48 cases of typeⅡstrains.Among them,65 cases(39.4%)were resistant to clarithromycin,47 cases(28.5%)were resistant to metronidazole,34 cases(20.6%)were resistant to clarithromycin and metronidazole.A total of 78 cases(47.3%)were resistant to antibiotics,and 87 cases(52.7%)were sensitive to antibiotics.There was a statistically significant correlation between the types of Hp strains and the characteristics of gastric mucosal lesions(P<0.001).There was no significant correlation between clarithromycin,metronidazole resistance,clarithromycin and or metronidazole dual resistance and Hp strain genotyping(P>0.05).CONCLUSION Type I Hp infection is more likely to cause gastric mucosal lesions,and there was no significant association between the Hp strains genotyping and antibiotic resistance.