深圳地区幽门螺杆菌临床分离菌株的耐药性分析

doi:10.19871/j.cnki.xfcrbzz.2021.02.001

新发传染病电子杂志 ›› 2021, Vol. 6 ›› Issue (2): 79-83.doi: 10.19871/j.cnki.xfcrbzz.2021.02.001

• 论著 • 下一篇

深圳地区幽门螺杆菌临床分离菌株的耐药性分析

张淑贞¹, 李雪宏¹, 黄海燕¹, 陈海婷¹, 王湘雨², Barry Marshall³, Alfred Tay³

1.深圳市大鹏新区葵涌人民医院检验科,广东深圳 518119;
2.深圳市第二人民医院消化内科,广东深圳 518000;
3.西澳大学生物医学院幽门螺杆菌研究实验室,澳大利亚珀斯 6009

收稿日期:2020-12-31 出版日期:2021-05-31 发布日期:2021-06-24
通讯作者: Alfred Tay,E-mail：Alfred.tay@uwa.edu.au
基金资助:
1.深圳市医疗卫生三名工程项目（SZSM201510050）; 2.深圳市大鹏新区医疗健康集团2019年度科研项目（2019JTLCYJ005）

Analysis of antibiotic resistance of Helicobacter pylori in Shenzhen area

Zhang Shuzhen¹, Li Xuehong¹, Huang Haiyan¹, Chen Haiting¹, Wang Xiangyu², Barry Marshall³, Alfred Tay³

1. Clinical Laboratory Department of Shenzhen Dapeng New District Kuichong People Hospital, Guangdong Shenzhen 518119, China;
2. Gastroenterology Department of Shenzhen Second People's Hospital, Guangdong Shenzhen 518000, China;
3. Marshall Centre for Infectious Diseases Research and Training Helicobacter Research Laboratory, the University of Western Australia,Perth 6009, Australia

Received:2020-12-31 Online:2021-05-31 Published:2021-06-24

摘要/Abstract

摘要： 目的探讨深圳地区幽门螺杆菌（Helicobacter pylori,Hp）临床分离菌株的耐药情况,为临床抗生素的合理选用提供实验室依据。方法 2017年1月至2019年1月,对深圳市大鹏新区葵涌人民医院消化内科381例¹³C尿素呼气试验阳性的胃病患者行胃镜检查,采集胃窦及胃体部黏膜进行Hp培养和药物敏感试验,并对培养情况及药物敏感结果进行统计分析。结果 381例患者分离培养到Hp 315株,阳性率为82.68%（315/381）。Hp对抗生素的耐药率分别为阿莫西林0（0/231）、利福平2.22%（7/315）、环丙沙星23.81%（75/315）、克拉霉素32.69%（103/315）、甲硝唑83.17%（262/315）。Hp对上述5种抗生素均敏感者有46株,敏感率14.60%（46/315）,发生耐药269株,耐药率85.40%（269/315）,其中单一耐药率51.43%（162/315）,二重耐药率26.35%（83/315）,三重耐药率7.62%（24/315）。Hp耐药率与性别、年龄有一定的关系,主要表现为男性人群Hp多重耐药率随年龄增长而增长,且老年男性人群多重耐药率明显高于老年女性人群（P<0.05）。结论深圳地区幽门螺杆菌甲硝唑耐药率极高,不适宜做为一线治疗用药;阿莫西林耐药率极低,若患者对青霉素不过敏,应当作为首选用药;男性特别是老年男性是Hp耐药及多重耐药更为严重的人群,治疗选用药物时须注意过往服药史。

关键词: 幽门螺杆菌, 药物敏感试验, 耐药性, 抗菌药物

Abstract: Objective To explore the drug resistance of Helicobacter pylori(Hp) in Shenzhen and provide laboratory evidence for the selection of clinical antibiotics. Methods From January 2017 to January 2019, a total of 381 Hp positive participants were enrolled in this trial who had received ¹³C-urea breath test. They were examined by endoscopy and the gastric antrum/corpus mucosa were collected for Hp culture and antibiotic susceptibility test. The culture and antimicrobial results were counted and analyzed. Results A total of 315 Hp strains were isolated from 381 patients. The positive rate was 82.75% (315/381). The resistance rate of Hp to amoxicillin was 0% (0/231), rifampicin 2.22% (7/315), ciprofloxacin 23.81% (75/315), clarithromycin 32.69% (103/315), metronidazole 83.17% (262/315). 46 strains of Hp were sensitive to the above five antibiotics and the sensitivity rate was 14.60% (46/315). 269 strains of Hp were resistant to at least one antibiotic and the resistance rate was 85.40% (269/315), of which the single resistance rate was 51.43% (162/315), the double resistance rate is 26.35% (83/315), and the triple resistance rate is 7.62% (24/315).The gender and age will affect the resistance rate of Hp. The multi-drug resistance rate of Hp in male population increased with age, and the multi-drug resistance rate of elderly males was significantly higher than that of elderly females (P<0.05). Conclusions The metronidazole resistance rate of in Shenzhen is extremely high, which is not suitable for first-line treatment; The resistance rate of Helicobacter pylori amoxicillin is extremely low. Penicilin is recommended to be the first choice of treatment unless patient is allergic to the drug; Elderly males are more likely to have Hp resistance and multi-drug resistance. The history of antibiotic used should be carefully noted.

Key words: Helicobacter pylori, Antibiotic susceptibility test, Resistance rate, Antimicrobial agents

张淑贞, 李雪宏, 黄海燕, 陈海婷, 王湘雨, Barry Marshall, Alfred Tay. 深圳地区幽门螺杆菌临床分离菌株的耐药性分析[J]. 新发传染病电子杂志, 2021, 6(2): 79-83.

Zhang Shuzhen, Li Xuehong, Huang Haiyan, Chen Haiting, Wang Xiangyu, Barry Marshall, Alfred Tay. Analysis of antibiotic resistance of Helicobacter pylori in Shenzhen area[J]. Electronic Journal of Emerging Infectious Diseases, 2021, 6(2): 79-83.

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深圳地区幽门螺杆菌临床分离菌株的耐药性分析

Analysis of antibiotic resistance of Helicobacter pylori in Shenzhen area

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