老年人群中四环素耐药幽门螺杆菌的16S rRNA基因突变特征与影响因素

Characteristics of 16S rRNA gene mutations and influencing factors of tetracycline-resistant Helicobacter pylori in the elderly

目的 探讨老年人群中四环素耐药的幽门螺杆菌(Helicobacter pylori,H.pylori)中16S rRNA基因突变的分子特征,分析H.pylori治疗效果、不同程度胃病等对H.pylori耐药的影响。方法 从胃黏膜组织样本中分离H.pylori菌株,采用E-test体外药敏试验检测H.pylori对四环素的耐药性。采用Sanger测序法分析16S rRNA基因序列,通过分子遗传进化分析软件(molecular evolutionary genetics analysis-X,MEGA-X)比对临床菌株与ATCC26695的序列差异。使用SPSS 20.0进行统计学分析。结果 从189份胃黏膜样本中分离的55株H.pylori来自老年患者,55株H.pylori对四环素的耐药率为14.5%。H.pylori对四环素的耐药与老年人群H.pylori治疗失败有相关性(P<0.05)。H.pylori对四环素耐药有关的突变位点为A926T和G927T,有统计学差异(P<0.05)。结论 上海地区老年人群中H.pylori对四环素的耐药率升高,16SrRNA基因中的A926T和G927T突变与H.pylori对四环素耐药有关。

Objective To explore the molecular characteristics of 16 S rRNA gene mutations of tetracycline-resistant Helicobacter pylori(H.pylori)in the elderly and to analyze the effects of radical treatment of H.pylori and different degrees of gastric diseases on the resistance to H.pylori.Methods H.pylori strains were isolated from gastric mucosal samples,and the drug resistance of H.pylori to tetracycline was detected by E-test in vitro drug susceptibility test.The 16 S rRNA gene sequence was analyzed by Sanger sequencing,and the sequence differences between clinical strains and ATCC26695 were compared by Molecular Evolutionary Genetics Analysis-X(MEGA-X).SPSS20.0 was used for statistical analysis.Results A total of 55 H.pylori strains were isolated from 189 gastric mucosal samples,and the resistance rate of H.pylori to tetracycline was 14.5%.The resistance rate of 55 H.pylori strains to tetracycline was 14.5 %.The resistance of H.pylori to tetracycline was correlated with the failure of H.pylori treatment in the elderly.P<0.05(the difference was statistically significant).The mutation sites related to the resistance of H.pylori to tetracycline were A926 T and G927 T.P<0.05(the difference was statistically significant).Conclusion The resistant rate of H.pylori to tetracycline in the elderly population in Shanghai is increasing.Mutations of A926 T and G927 T in the 16 S rRNA gene are associated with tetracycline resistance of H.pylori.