48例消化性溃疡患者幽门螺杆菌的耐药性调查

Investigation of Drug-resistant Helicobacter pylori Isolates from 48 Patients with Peptic Ulcer

对幽门螺杆菌 (Helicobacterpylori ,Hp)临床分离株进行药物敏感性试验及耐药性分析 ,为探求幽门螺杆菌感染的根除疗法提供依据。运用微需氧培养方法 ,从胃镜活检标本中分离幽门螺杆菌 ,利用琼脂稀释法测定幽门螺杆菌对抗生素的敏感性试验 ,将 2 1株Hp临床分离株进行 7种抗菌药物的敏感性及耐药性调查。从 4 8例消化性溃疡患者胃镜活检标本中分离出 2 1株幽门螺杆菌。 2 1株幽门螺杆菌对阿莫西林MIC范围 0 .5～ 8mg/L ,无耐药菌株 ;克拉霉素、替硝唑的MIC范围分别为 0 .12 5～ 0 .5mg/L和 4～ 8mg/L ,耐药率均为 4 .76 % ;四环素、利福平的MIC范围分别为 0 .5～ 1mg/L和 1～ 6 4mg/L ,耐药率分别为 4 .76 % ,9.5 2 % ;甲硝唑的MIC为 16～ 12 8mg/L ,红霉素的MIC为 0 .5～ 12 8mg/L ,耐药率较高 ,分别为 2 3.89%和5 7.15 %。此次分离的Hp对阿莫西林、克拉霉素、替硝唑有较高的敏感性 ;而对甲硝唑及红霉素耐药率高 ,应避免应用 ;阿莫西林、克拉霉素可作为本地区治疗Hp感染的主要药物 ;四环素、利福平可用于一线治疗失败后二线治疗 ;替硝唑可替代甲硝唑用于Hp的根除治疗。

To obtain direct proofs for irradiation of Helicobacter pylori(Hp), antibiotic susceptibility and resistance of Hp isolates were carried out.Hp were isolated from biopsy using anaerobic culture. Based on agar dilution method, antibiotic sensitivity of Hp was carried out.21 strains of Hp were identified from 48 patients with peptic ulcer. MIC of Amoxinllin is 0.5～8 mg/L, no resistant strains. Clarithromycin and Tinidazole are 0.125～0.5 mg/L and 4～8 mg/L, respectively, the resistant rate of them is 4.76%. Tetracyclin, and Rifampicin is 0.5～1 mg/L and 1～64 mg/L, respectively, and the resistant rate is 4.76% and 9.52%. MIC of Metronidazole is 16～128 mg/L, Erythromycin is 0.5～128 mg/L, showed higher rate of resistance, 23.89% and 57.15%, respectively. Tetracyclin, and Rifampicin is 0.5～8 mg/L, 0.125～1 mg/L.Hp isolated from patients showed a higher sensitivity to Amoxinllin, Clarithromycin and Tinidazole. On other hand, Hp isolates exhibit more non-susceptibility to Metronidazole and Erythromycin.;