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幽门螺杆菌耐药性检测 总被引:22,自引:0,他引:22
目的 体外观察北京地区人群幽门螺杆菌(Hp)菌株对临床常用4种抗菌药物的敏感性和耐药性。方法 ①菌株:Hp菌株20株(2株国际标准菌株,18株临床分离株),同时以金黄色葡萄球菌ATCC25923为质控菌株。②药物:羟氨苄青霉素,克拉霉素,甲硝唑,呋喃唑酮。③药敏试验:滤纸片琼脂扩散法。结果 甲硝唑耐药率94.4%,克拉霉素、呋喃唑酮耐药率5.6%,羟氨苄青霉素耐药率0。结论 北京地区人群Hp菌株甲 相似文献
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幽门螺杆菌体外药敏和耐药性的研究 总被引:5,自引:0,他引:5
随着幽门螺杆菌 (Hp)根除治疗中抗生素的广泛应用 ,Hp的药敏和耐药性问题日益突出。我们采用E test试验对Hp感染率较高的西安地区Hp药敏和耐药问题加以探讨。1.材料和方法 :(1)菌液制备 :将 5 0株Hp临床分离株制成菌悬液 ,使其浊度达到 0 .5麦氏单位 ,并计数为 3× 10 8菌落形成单位 (CFU/ml)。 (2 )E test试剂条 :瑞典ABBiodisk公司产品。 (3)E test试验 :用无菌棉拭子将所制菌液均匀涂布于MHA琼脂平板上 ,待平板干后 ,取试条放置于琼脂表面 (1条 /90mm平皿 ) ,37℃微需氧培养 72h后 ,终点法… 相似文献
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目的 了解徐州及其周边地区幽门螺杆菌(Helicobacter pylori,H.pylori)感染菌株的耐药现况,并为制定较为精准的治疗方案提供科学依据。方法 采用随机抽样法,抽取2019年3月1日至2021年5月14日在徐州医科大学附属徐州市立医院就诊的H.pylori阳性患者共450例,所有患者均取胃黏膜标本进行免疫组化检测、H.pylori分离培养及药敏试验,并对检测结果进行进一步统计分析。结果 徐州及其周边地区感染H.pylori菌株对甲硝唑、克拉霉素、左氧氟沙星、阿莫西林和呋喃唑酮的耐药率分别为90.10%、58.15%、49.84%、1.60%和0.64%,四环素暂未发现耐药。有16例(5.11%)药物均敏、88例(28.12%)单药耐药、89例(28.43%)双重耐药、119例(38.02%)三重耐药及1例(0.32%)四重耐药。H.pylori对克拉霉素、左氧氟沙星的耐药性与抗生素使用史有关,差异有统计学意义(P<0.05);既往有根除治疗史患者的H.pylori体外培养成功率低于初治患者,差异有统计学意义(P<0.05)。结论 徐州及其周边地区感染的H.... 相似文献
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目的 通过调查宁夏石嘴山地区590例志愿者幽门螺杆菌(HP)感染及耐药情况,分析该地区HP感染及耐药的特点。方法 选取宁夏石嘴山地区的590例志愿者,采用自拟HP调查问卷的形式调查志愿者的临床资料,采用尿素14C呼气试验(14C-UBT)检测HP感染情况,胃镜下留取HP感染者胃黏膜标本行HP体外培养;取培养菌落采用革兰染色、触酶试验、尿素酶试验法确认为HP菌株后分离培养出的HP菌株,采用Kirby Bauer纸片扩散法检测HP菌株对阿莫西林、呋喃唑酮、四环素、甲硝唑、克拉霉素、左氧氟沙星的耐药性。对比分析不同基线资料志愿者HP感染及耐药情况。结果 590例志愿者经14C-UBT检测共发现300例感染HP,HP感染率为50.84%。300例感染HP志愿者经体外培养共分离出HP阳性菌株160株,HP菌株检出率为53.33%。男性、生活地区为农村、家庭月收入<3 000元、受教育程度在初中及以下、吸烟、经常共用餐具及水杯的志愿者HP感染率较高(P均<0.05)。160例HP阳性菌株中,对甲硝唑、左氧氟沙星、克拉霉素、阿莫西林、呋喃唑酮、四环素耐药的菌株数分别为147、70、69、... 相似文献
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目的:了解贵阳地区儿童感染幽门螺杆菌(Helicobacter pylori,H.pylori)临床分离株对常用抗H.pylori抗生素甲硝唑、克拉霉素、阿莫西林等的体外敏感性,以指导临床用药根除H.pylori感染.方法:收集2011-10/2014-06贵阳市儿童医院行胃镜检查的患儿胃黏膜标本进行H.pylori分离培养,对分离鉴定后的菌株采用界值法进行甲硝唑、克拉霉素、阿莫西林、左氧氟沙星的敏感性试验.结果:从434例患儿胃黏膜中培养出H.pylori63株(14.5%),63例H.pylori菌株中3株为敏感菌株,60株为耐药菌株,其对甲硝唑、克拉霉素、阿莫西林、左氧氟沙星的耐药率分别为57.1%、85.7%、38.1%、90.5%.二重、三重、四重耐药率分别为90.5%(57/63)、57.1%(36/63)、38.1%(24/63).结论:贵阳地区儿童感染H.pylori对阿莫西林敏感性高于对其他常用药物的敏感性;对左氧氟沙星和克拉霉素的耐药率较高,并且多重耐药率较高. 相似文献
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上海地区幽门螺杆菌对抗生素耐药率的变迁 总被引:70,自引:0,他引:70
甲硝唑和克拉霉素是根除幽门螺杆菌 (Hp)感染的主要抗生素 ,Hp对这些抗生素耐药是治疗失败的主要原因。我们调查了上海地区 1995~ 1999年间Hp对甲硝唑和克拉霉素耐药率的变化情况 ,现报道如下。1.Hp菌株 :Hp菌株分离自我们在上海地区几家工厂职工胃镜普查所取的胃黏膜活检标本。随机选取 1995、1997和1999年分离、保存的Hp菌株各 5 0株 ,均接种于含 7%马血的Skirrow培养基中 ,微氧条件培养 3~ 5d ,经生化、涂片鉴定为典型的Hp。2 .药敏试验 :应用E test(ABBiodisk ,Solwa,Sweden)测定Hp… 相似文献
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目的调查南京地区幽门螺杆菌(Helicobacter pylori,H.pylori)对多种抗生素的耐药现状及近5年变化趋势,为本地区根除H.pylori经验性用药提供依据。方法于2017年7月至2019年7月收集经呼气试验或快速尿素酶试验证实为H.pylori阳性的736例患者胃黏膜组织标本行H.pylori分离培养,采用Kirby-Baner(KB)药敏纸片法行药敏试验。并将其结果与2014年5月至2015年5月H.pylori药敏检测结果进行比较。结果药敏试验显示,2017年7月至2019年7月H.pylori对阿莫西林、克拉霉素、左氧氟沙星、呋喃唑酮、四环素和甲硝唑的耐药率分别为3.80%、42.53%、25.95%、1.49%、1.08%、84.78%。2017年7月至2019年7月接受初次根除与非初次根除H.pylori对阿莫西林、克拉霉素、左氧氟沙星、呋喃唑酮、四环素和甲硝唑的耐药率分别为2.53%vs 7.65%、33.82%vs 68.85%、18.63%vs 48.09%、0.72%vs 3.83%、0.72%vs 2.19%、82.64%vs 91.26%。与2014年5月至2015年5月相比,甲硝唑增幅最大,由2014年5月至2015年5月的60.5%升至近期84.78%,其次为克拉霉素,从29.5%升至42.53%,左氧氟沙星从14.7%升至25.95%,差异均有统计学意义(P<0.05)。结论本地区H.pylori感染者初次根除时对阿莫西林、呋喃唑酮、四环素耐药率较低。对于非初次根除患者,临床医师应结合地区耐药率、个人抗生素暴露史、经济效益比、药物不良反应、药物可获得性等多方面综合考虑。 相似文献
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对幽门螺杆菌有效中西药物筛选的实验研究 总被引:27,自引:0,他引:27
本研究经药敏试验从20种清热解毒中药中筛选出丹皮、乌梅、大黄、黄柏、三七、丹参、白芍、黄连8种对幽门螺杆菌有效的中药,抑菌直径6.88mm±0.12mm~9.25mm±0.42mm,上述药物与丹参、人参、"胃忧愈"或三种药物按排列组合方法进行药敏试验,结果与"胃忧愈"及:三种药物联合抑菌作用增强(8.13mm±1.06mm~13.62mm±0.14mm,P<0.01或P<0.05)达到中度敏感。14种抗生素的药敏试验显示为中度或高度敏感,每种抗生素与De-Nol和/或甲硝唑联合作用明显增加,这可能与其作用方式不同而产生协同作用有关。 相似文献
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幽门螺杆菌耐药问题研究进展 总被引:8,自引:0,他引:8
许丽莉 《国外医学:消化系疾病分册》1999,19(3):146-148
研究表明,幽门螺杆菌的耐药性是造成根除Hp失 主要原因,已日益受到人们的关注。Hp对大环内酯类,硝基咪类、喹 耐药机制不同,耐药率在世界各地区也有很大判别探寻耐药病例的治疗方案成为临床研究所面临的问题。 相似文献
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66例幽门螺杆菌感染者耐药性分析 总被引:6,自引:0,他引:6
目的通过对66例幽门螺杆菌感染(HP)者临床分离菌株的培养和药敏试验,分析幽门螺杆菌对常用抗生素的耐药性,为临床选用抗生素治疗HP提供依据。方法采用Kiby-bauer法检测HP临床分离菌株对阿莫西林、甲硝唑、克拉霉素、左氧氟沙星、四环素、呋喃唑酮的耐药率,并分析性别、年龄及不同疾病对耐药率的影响。结果幽门螺杆菌对阿莫西林、甲硝唑、克拉霉素、左氧氟沙星、四环素、呋喃唑酮的耐药率分别为4.0%、32.0%、10.0%、24.0%和6.0%、0%;甲硝唑在女性与男性中的耐药率存在差异(P〈0.05)。不同年龄和不同临床疾病患者,HP对各抗生素耐药率比较无显著性差异(P〉0.05)。结论本地区幽门螺杆菌对呋喃唑酮、阿莫西林、四环素、克拉霉素的敏感性较高,对甲硝唑、左氧氟沙星的耐药耐药性较高;女性甲硝唑耐药高于男性,各抗生素耐药与患者年龄和疾病种类无关。 相似文献
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中国幽门螺杆菌耐药研究现状 总被引:33,自引:0,他引:33
胡伏莲 《胃肠病学和肝病学杂志》2008,17(7):517-518
中国是一个幽门螺杆菌(H.pylori)感染率较高的国家,H.pylori的感染率42%~90%,所以H.pylori感染的治疗是H.pylori研究领域中的重点,而H.pylori感染治疗失败主要原因是H.pylori对抗生素的耐药性,所以H.pylori感染治疗中核心问题是日.pylori对抗生素的耐药性,其耐药性也是H.pylori感染研究中的重点课题。近年我国对H.pylori耐药研究已有新j生展,本文重点介绍如下5个方面:①H.pylori对常用抗生素耐药情况及地区差异性;②H.pylori对常用抗生素耐药性随时间变迁而逐渐上升;⑧H.pylori对四环素和左氧氟沙星耐药情况;④H.pylori耐药对H.pylori根除效果的影响;⑤如何克服H.pylori对抗生素耐药性。 相似文献
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目的分析顺德地区肺结核病耐药情况,为制定下一阶段肺结核防治计划提供科学依据。方法选取2014年1月至2014年11月新增涂阳肺结核患者399例,在此过程中复治患者有71例,对就诊患者中疑似感染人员留取夜间痰、清晨痰和即时痰三份标本进行抗酸杆菌涂片检查和培养,培养阳性标本进行菌种鉴定,对结核分枝杆菌进行异烟肼(H)、链霉素(S)、利福平(R)、乙胺丁醇(E)、左氧氟沙星(LFX)、卡那霉素(KM)、对氨基水杨酸(PAS)7种一、二线药物敏感试验。收集患者初治、复治过程中耐药种类、耐药程度,与性别、年龄、治疗类型间的关系等数据,并进行统计学分析。结果无论在初治患者还是复治患者中R、S、H、E均为患者主要耐受性药物,两组单种耐药性比较数据差异不明显,不具有统计学意义(P0.05)。复治患者较初治患者耐多种药物水平有所增加,两组数据比较,差异明显,具有统计学意义(P0.05)。治疗类型和年龄能够影响患者多种药物耐受性,复治和老年患者中多种药物耐受性增加。结论顺德地区耐药和耐多药肺结核防止和控制工作仍不能忽视,应加强宣传教育和管理,以期降低耐药性。 相似文献
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L-forms of H. pylori 总被引:1,自引:0,他引:1
AIM: To study the occurrence of L-forms of H. pyloriinfection in patients with peptic ulcers and its association with possible changes of cellular immune function in the patients.METHODS: Endoscopic biopsy specimens of gastric antrum and gastric corpus were taken from 228 patients with peptic ulcers and inoculated into Skirrow selective medium for H.pylorivegetative forms and special medium for H. pylori Lforms, followed by bacterial isolation and identification. And peripheral venous blood of the patients was taken to detect the percentage of CD3+, CD4+ and CD8+ with biotin-streptavidin (BSA) and the level of IL-2, IL-6 and IL-8 with ElISA.RESULTS: (1) The detection rates of H. pyloriL-forms and vegetative forms in the patients were 50.88 % (116/228)and 64.91 % (148/228) respectively, and the co-infection rate of H. pyloriL-forms and vegetative forms was 78.38 % (116/148). To be more exact, the detection rates of H. pylori L-forms in male and female patients were 57.04 % (77/135) and 41.94 % (39/93) respectively, and statistics found significant difference between them (P<0.05). Furthermore, the detection rates of H. pyloriL-forms in patients aged 14 years-, 30 years-, 40 years- and 50 years- were 31.91%(15/47), 42.86 % (24/56), 56.94 % (41/72) and 67.92 %(36/53) respectively, and there was significant difference between them (P<0.011). (2) The percentages of CD3+, CD4+,CD8+, the ratio of CD4+/CD8+, and the level of IL-2, IL-6,IL-8 in H. pylori-positive patients were (52.59±5.44) %,(35.51±5.74) %, (27.77±8.64) %, (1.56±0.51), (2.66±0.47)mg/L, (108.62±5.85) ng/L and (115.79±7.18) ng/Lrespectively, compared with those in H. pylori-negative patients, the percentages of CD3+, CD4+ and the ratio of CD4+/CD8+ decreased, but the level of IL-2, IL-6 increased, and the difference was significant (P<0.001-P<0.011).Moreover, the percentages of CD3+, CD4+, CD8+, the ratio of CD4+/CD8+, and the level of IL-2, IL-6, IL-8 in the patients with mixed infection of bothH. pyloriL-forms and vegetative forms were (51.69±5.28) %, (34.75±5.89) %, (27.15±7.45) %, (1.48±0.47), (2.16±0.38) mg/L, (119.45±5.44) ng/L and (123.64±6.24) ng/L respectively, compared with those in patients with simple infection of H. pylorivegetative forms,the percentage of CD4+, the ratio of CD4+/CD8+ and the level of IL-2 increased, but the level of IL-6 and IL-8decreased, statistical difference was found between them (P<0.001-P<0.05).CONCLUSION: L-forms variation often occurs in patients with peptic ulcers who are infected byH. pylori, which is commonly found in male patients and related to ages. The L-forms variation of H. pylori can be an important factor causing disorder of cellular immune function in the patients with peptic ulcers who are infected by H. pylori. 相似文献
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MasaoOmata 《胃肠病学》2000,5(B08):62-63
The infection of H. pylori was conventionally diagnosed by microscope identification and isolation ofthe pathogen by culture. However, these procedures are fairly time consuming and not sensitive enough. We have developed highly sensitive and specific method to detect the infection by PCR based amplification of nucleicacid. Using this procedure, we are studying the molecular aspect of this particular pathogen. The genetic analysis of clarithromycin resistant strain revealed that the appearance of resistant strain is not due to the conversion from sensitive strain to resistant, 相似文献
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目的探讨幽门螺杆菌(H.pylori,Hp)根除的最佳方案及相关因素。方法收集2007年1月至2010年12月于北京大学第三医院消化内科行胃镜检查病理组织学Warthin-Starry(WS)染色阳性,经规律根除并在完成治疗后停药4周以上,并行13C呼气试验复查的患者,共计2335例患者入选,收集患者性别、年龄、上胃肠道基础疾病、治疗次数、治疗方案,治疗疗程,用药种类,药物剂量和13C呼气试验结果。采用安徽合肥皖仪生物电子有限公司生产的ZC-202 13C质谱仪对患者的Hp根除结果进行判断,结果≥4定义为Hp阳性,提示根除失败;结果在0~<4之间为Hp阴性,即根除成功。结果Hp根除率为78.0%,初治组为78.7%,复治组为66.4%(P=0.004)。初治患者中,四联、三联、序贯治疗组根除率分别为83.2%、73.5%、71.5%(P=0.004);14 d、10 d、7 d疗程组根除率分别为89.5%、78.8%、74.1%(P<0.01);应用及未应用质子泵抑制剂(PPI)者的根除率分别为81.3%、63.78%(P<0.01);7 d四联初治方案中,阿莫西林联合克拉霉素方案及阿莫西林联合甲硝唑或替硝唑方案的根除率分别为90.2%、74.1%(P=0.002)。结论四联治疗方案的Hp根除率高于三联治疗。14 d和10 d疗程组的根除率高于7 d组。应用PPI组的根除率高于未应用PPI组。以PPI和铋剂为基础的7 d四联初治方案中,阿莫西林联合克拉霉素组的根除率高于阿莫西林联合甲硝唑或替硝唑组。 相似文献
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Analysis of immune responses against H pylori in rabbits 总被引:2,自引:0,他引:2
Islam K Khalil I Ahsan CR Yasmin M Nessa J 《World journal of gastroenterology : WJG》2007,13(4):600-606
AIM: To investigate the immunogenicity of H pylori proteins, to evaluate the production rate of anti H pylori IgG antibodies in relation to time and to demonstrate the fidelity of newly optimized in-house enzymelinked immunosorbent assay (ELISA) technique as an alternative for H pylori infection assay.
METHODS: In the present study, 100 μg of formalinfixed H pylori whole cell antigens was injected into an experimental animal (New Zealand white female rabbit) intramuscularly on d 0, 16, 27 and 35. The first two doses were injected with adjuvants. On d 0, a serum sample was collected from the rabbit before immunization and this pre-immunized serum was used as a negative control for the whole study. To evaluate the immunogenic responses of the injected antigen, serum samples were collected from the rabbit at regular intervals up to d 42. The sera were analyzed using inhouse ELISA and Western blot techniques.
RESULTS: The production of anti Hpylor/IgG antibodies in the rabbit in response to the injected antigen increased almost exponentially up to d 14 and after that it was maintained at the same level until the last day (d 42). By analyzing the immune profiles of immunized sera, 11 proteins were identified to be immunogenic, among them 2 (approximately 100 kDa and 85 kDa) were most prominent.
CONCLUSION: Analysis of the immune responses against pathogenic microorganisms like H py/ori is necessary for the development of various diagnostic and preventive approaches. The results of this experiment reveal that the formalin-fixed H pylori whole cell antigens injected into the rabbit are highly immunogenic. These prominent proteins (approximately 100 kDa and 85 kDa) might have higher immunogenic effects among humans infected with H pylori and some of these immunogenic proteins can be included in diagnostic approaches based on serology and also for vaccine formulation. The in- house ELISA is a promising alternative compared to invasive techniques. 相似文献
METHODS: In the present study, 100 μg of formalinfixed H pylori whole cell antigens was injected into an experimental animal (New Zealand white female rabbit) intramuscularly on d 0, 16, 27 and 35. The first two doses were injected with adjuvants. On d 0, a serum sample was collected from the rabbit before immunization and this pre-immunized serum was used as a negative control for the whole study. To evaluate the immunogenic responses of the injected antigen, serum samples were collected from the rabbit at regular intervals up to d 42. The sera were analyzed using inhouse ELISA and Western blot techniques.
RESULTS: The production of anti Hpylor/IgG antibodies in the rabbit in response to the injected antigen increased almost exponentially up to d 14 and after that it was maintained at the same level until the last day (d 42). By analyzing the immune profiles of immunized sera, 11 proteins were identified to be immunogenic, among them 2 (approximately 100 kDa and 85 kDa) were most prominent.
CONCLUSION: Analysis of the immune responses against pathogenic microorganisms like H py/ori is necessary for the development of various diagnostic and preventive approaches. The results of this experiment reveal that the formalin-fixed H pylori whole cell antigens injected into the rabbit are highly immunogenic. These prominent proteins (approximately 100 kDa and 85 kDa) might have higher immunogenic effects among humans infected with H pylori and some of these immunogenic proteins can be included in diagnostic approaches based on serology and also for vaccine formulation. The in- house ELISA is a promising alternative compared to invasive techniques. 相似文献