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1.
1134例幽门螺旋杆菌培养及药敏分析   总被引:1,自引:0,他引:1  
目的 了解嘉兴地区H.pylori感染、耐药情况及依据药敏试验行抗H.pylori治疗后,H.pylori根除的情况.方法 选取1134例上消化道疾病患者胃黏膜组织,于微需氧环境的分离培养基上培养.采用抗生素药敏试验纸片琼脂扩散法(简称K-B法),对分离到的H.pylori菌株进行药物敏感试验,抗生素选用甲硝唑、阿莫西林、克拉霉素、呋喃唑酮、庆大霉素及左氧氟沙星.所有H.pylori培养阳性患者,均依据药敏试验结果进行抗H.pylori治疗,4周后复查.结果 1134例患者中,H.pylori分离培养阳性者341例,阳性率30.07%.病理组织学检测阳性者477例,阳性率42.06%,明显高于分离培养阳性者(P<0.001).对341例分离培养的H.pylori菌株进行药敏试验.甲硝唑耐药率最高,左氧氟沙星最低,依次为甲硝唑(99.12%)、阿莫西林(46.04%)、克拉霉素(34.02%)、呋喃唑酮(16.42%)、庆大霉素(6.45%)、左氧氟沙星(0.59%).细菌对抗生素的敏感度左氧氟沙星最高.甲硝唑最低,依次为左氧氟沙星(20.51%)、庆大霉素(18.43%)、阿莫西林(17.04%)、呋喃唑酮(16.92%)、克拉霉素(15.54%)、甲硝唑(10.33%).结论 依据药敏试验进行抗H.pylori治疗,是抗H.pylori治疗的最佳选择.  相似文献   

2.
目的了解河南省~(13)C呼气试验结果阳性的患者中分离的幽门螺杆菌(H.pylori)对利福昔明的药物敏感性及其他6种常用抗菌素(克拉霉素、左氧氟沙星、呋喃唑酮、四环素、甲硝唑、阿莫西林)的耐药情况,以掌握河南省H.pylori对上述抗菌素的药敏谱,指导临床用药。方法选取2019年4月至2019年12月在我院行~(13)C-快速尿素酶呼气试验检查(~(13)C-UBT)且结果为H.pylori阳性的河南省患者为本次研究对象。常规胃镜操作下取胃黏膜组织样本,送我院H.pylori实验室培养鉴定,获得H.pylori菌株,针对上述7种抗生素进行药敏试验。结果在248例送检胃黏膜组织标本中成功分离H.pylori菌株共154例,体外药敏试验分析,H.pylori对克拉霉素、左氧氟沙星、呋喃唑酮、阿莫西林、甲硝唑、利福昔明耐药率分别为29.22%、27.92%、11.04%、5.84%、83.77%、7.79%。未能发现对四环素耐药的H.pylori菌株。对上述所有抗生素均敏感的菌株共9例,占总菌株的5.84%;58例菌株对单种抗生素耐药,占总菌株的37.66%;87例H.pylori菌株对多种抗生素耐药,占总菌株的56.49%。结论河南省H.pylori对利福昔明的药物敏感性较高,可作为抗H.pylori的药物选择;对甲硝唑、克拉霉素、左氧氟沙星的耐药率较高,且存在交叉耐药,不宜作为河南省临床抗H.pylori的首要选择;对呋喃唑酮、阿莫西林、四环素耐药率较低,亦可选择上述药物用于临床常规治疗。  相似文献   

3.
回顾性分析2013年11月至2014年8月、2016年6至12月香港大学深圳医院H.pylori初治患者根除方案和根除率,结果显示H.pylori根除率呈下降趋势[总根除率76.5%(202/264)比73.8%(276/374)],含左氧氟沙星方案使用比例增加3.2倍[12.9%(34/264)比54.5%(204/374)]。募集深圳多中心2016年9月至2018年4月碳13尿素呼气试验检测结果呈阳性、初治、行胃镜检查患者,H.pylori培养阳性率为74.7%(557/746),药物敏感试验结果显示阿莫西林耐药率为1.3%(7/557),克拉霉素为34.1%(190/557),左氧氟沙星为42.4%(236/557),甲硝唑为92.5%(515/557),呋喃唑酮为0,盐酸四环素为0,甲硝唑、克拉霉素、左氧氟沙星联合耐药率为56.2%(313/557);依据药物敏感试验结果H.pylori根除成功率为94.2%(483/513),依据本地区耐药背景,H.pylori根除率为86.1%(136/158)。左氧氟沙星、克拉霉素高耐药是导致深圳地区H.pylori整体根除率下降的主要原...  相似文献   

4.
背景:幽门螺杆菌(H.pylori)对抗生素的耐药率在世界范围内呈上升趋势,但存在地域差异。目的:调查上海市青浦区H.pylori对5种根除治疗方案中常用抗生素的耐药情况。方法:选取青浦区两所医院因上消化道症状行胃镜检查、快速尿素酶试验阳性并符合纳入和排除标准的患者,取胃窦黏膜分离培养H.pylori.采用Kirby-Bauer纸片扩散法行药敏试验。结果:成功分离培养出120株H.pylori临床菌株,对甲硝唑、阿莫西林、克拉霉素、左氧氟沙星和呋喃唑酮的耐药率分别为82.5%、22.5%、36.7%、41.7%和0.8%。耐药率与患者性别无关;慢性胃炎菌株对左氧氟沙星的耐药率显著高于十二指肠溃疡菌株(P〈0.05)。60.8%的菌株对两种以及两种以上抗生素联合耐药。结论:青浦区H.pylori对甲硝唑、阿莫西林、克拉霉素、左氧氟沙星的耐药情况相当严重且多重耐药率高。初次根除治疗失败后.再次治疗时可在药敏试验指导下选择有效抗生素。呋喃唑酮可作为当地根除治疗方案的一线用药.  相似文献   

5.
目的分析江津地区幽门螺杆菌(H.pylori)的耐药情况,探讨对H.pylori耐药菌株合理使用抗生素的方法。方法对首次做胃镜检查H.pylori尿素酶试验阳性的患者,检查前2周内未服用过抗菌、铋剂等药物,用琼脂稀释法和E-test法检测H.pylori对阿莫西林、克拉霉素和甲硝唑的耐药情况,同时行药敏试验检测H.pylori的药物敏感情况。结果江津地区H.pylori菌株对阿莫西林、克拉霉素、甲硝唑和克拉霉素双重耐药分别为1.8%(1/57)、15.8%(9/57)和54.4%(31/57);H.pylori菌株对呋喃唑酮高度敏感,对左氧氟沙星、青霉素敏感。不同性别和病种对甲硝唑和克拉霉素的耐药率无显著性差异(P>0.05)。结论重庆市江津地区H.pylori对甲硝唑和克拉霉素耐药现象已经相当普遍,对阿莫西林的耐药情况也不容忽视。医生应选择敏感药物使用,必要时适当延长抗H.pylori用药时间以增强疗效。  相似文献   

6.
背景:幽门螺杆菌(Hp)对抗菌药物的耐药性不断增加,已成为导致其根除率降低的主要因素。目的:探讨影响Hp耐药性的危险因素。方法:回顾性分析2016年12月—2021年3月陆军特色医学中心收治的396例Hp感染患者的相关资料。采用药敏试验评估患者对6种抗菌药(甲硝唑、克拉霉素、左氧氟沙星、阿莫西林、四环素、呋喃唑酮)的耐药情况。应用非条件Logistic回归分析探讨影响Hp耐药性的危险因素。结果:396例Hp感染患者中,对甲硝唑、克拉霉素、左氧氟沙星、阿莫西林、四环素、呋喃唑酮的耐药率分别为96.5%、45.5%、41.9%、0.3%、0.3%、0。多因素分析表明,既往方案使用过克拉霉素为克拉霉素耐药的危险因素(P<0.001),年龄>40岁为左氧氟沙星耐药的危险因素(P<0.001)。结论:甲硝唑、克拉霉素和左氧氟沙星的耐药率较高,在没有药敏试验结果支持的情况下应避免使用含上述抗菌药物的方案,特别是既往方案使用过克拉霉素或年龄>40岁的患者,经验性治疗应优先考虑使用阿莫西林、四环素和呋喃唑酮。  相似文献   

7.
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   

8.
目的了解西安地区就医人群幽门螺杆菌(Hp)对甲硝唑、克拉霉素、阿莫西林、四环素、左氧氟沙星的耐药情况及变化趋势并对其进行分析,以指导临床合理治疗。方法 120例Hp阳性慢性胃炎及胃十二指肠溃疡患者,取胃黏膜组织标本行Hp培养和药敏试验。结果共有62例Hp菌株培养阳性,Hp对甲硝唑、阿莫西林、四环素、克拉霉素、左氧氟沙星的耐药率分别为61.3%、6.5%、4.8%、33.9%、25.8%。结论西安地区Hp对甲硝唑、阿莫西林、四环素、克拉霉素、左氧氟沙星的耐药率较2008年相比有所升高。严格掌握Hp根除的适应症,采取规范化治疗,合理选择抗生素是Hp根除治疗成功的关键。  相似文献   

9.
目的分析浙江地区幽门螺杆菌(Helicobacter pylori,H.pylori)耐药情况,并比较不同耐药检测方法的一致性.方法选择2017-06/2017-09进行胃镜检查的305例患者,取胃黏膜组织进行H.pylori菌株分离鉴定,对分离的127个菌株进行6种抗生素的药敏实验,提取菌株的DNA,以荧光定量PCR法和测序法对克拉霉素耐药相关基因23S rRNA和左氧氟沙星耐药相关基因gyrA进行扩增和测序.结果在305份胃黏膜活检标本中,分离出H.pylori 127株.127株H.pylori中124株为耐药菌株,3株为敏感菌株.阿莫西林、盐酸四环素、呋喃唑酮无耐药菌株;克拉霉素、左氧氟沙星、甲硝唑耐药率分别为33.86%(43/127)、44.88%(57/127)、91.34%(116/127)、三重耐药率为18.90%(24/127);克拉霉素和左氧氟沙星相关的主要耐药基因及其突变位点分别为23S rRNA(A2143G)、gyrA(C261A/G),突变频率分别为42.5%(54/127)和15.0%(19/127).不同耐药检测方法的一致性比较:荧光定量PCR法与测序法检测耐药突变一致性较高,与药敏培养法一致性相对较差.结论浙江地区对克拉霉素、左氧氟沙星耐药率均达到很高,在临床应用这些抗生素需结合耐药性,选择敏感的抗生素个体化地用药,提高根除效率.  相似文献   

10.
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   

11.
目的研究河西走廊地区上消化道疾病患者幽门螺杆菌(Hp)的感染及对抗生素的耐药状况。方法收集武威、金昌、张掖三地患者的胃黏膜标本,微需氧培养分离Hp,K-B纸片法检测Hp对6种抗菌药物的耐药性。结果从314例患者中分离出Hp 81株,分离率25.80%;消化性溃疡患者中Hp的分离阳性率(46.43%)显著高于慢性胃炎组(23.32%)(P<0.05),15~30岁年龄组人群Hp分离阳性率(52.63%)显著高于61岁以上年龄组(13.16%)(P<0.05)。Hp对常用6种抗菌药物的耐药性依次为:甲硝唑(47.89%),左氧氟沙星(8.45%),阿莫西林(4.23%),四环素(2.82%),克拉霉素(1.41%),呋喃唑酮(0)。胃癌组分离的Hp对左氧氟沙星的耐药率(37.50%)显著高于慢性胃炎组(3.85%)。结论 Hp感染在河西走廊地区上消化道疾病中伴有重要角色;该地区流行的Hp对甲硝唑耐药率较高,在一线根除方案中应尽量避免使用该药物;呋喃唑酮、阿莫西林等可以作为根除治疗的主要药物。  相似文献   

12.
幽门螺杆菌临床分离株耐药性研究   总被引:15,自引:0,他引:15  
目的 分析石家庄地区幽门螺杆菌临床分离株对多种抗生素的药物敏感性情况。方法  2 0 0 2 - 11~2 0 0 3- 12河北医科大学第三医院消化科采用滤纸片琼脂扩散法检测 5 5株临床分离株。对甲硝唑、奥硝唑、阿奇霉素、克拉霉素 ,阿莫西林、四环素、呋喃唑酮的药物敏感性。结果 甲硝唑耐药率 92 73% ,奥硝唑耐药率85 4 5 % ,阿奇霉素耐药率 4 5 4 5 % ,克拉霉素耐药率 9 0 9% ,阿莫西林、四环素、呋喃唑酮耐药率均为 0。结论 石家庄地区幽门螺杆菌对甲硝唑、奥硝唑、阿奇霉素耐药率较高 ,同时存在克拉霉素耐药 ,未发现阿莫西林、四环素、呋喃唑酮耐药株。  相似文献   

13.
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   

14.
BACKGROUND: Therapy for Helicobacter pylori is generally empiric despite the fact that resistance to metronidazole and clarithromycin compromise therapeutic efficacy. The aim of this study was to aid clinicians in choosing a course of therapy for H pylori infection in the United States. METHODS: The frequency of primary clarithromycin and metronidazole resistance among H pylori isolated from patients enrolled in US-based clinical trials between 1993 and 1999 was reviewed in relation to patient age, sex, region of the United States, and test method (Etest and 2 agar dilution procedures). RESULTS: Clarithromycin and metronidazole resistance rates were based on the results of 3439 pretreatment Etest determinations and 3193 agar dilution determinations. Sex and age were available on 900 and 823 individuals, respectively. Metronidazole resistance was 39% by Etest and 21.6% by agar dilution (P<.001). Clarithromycin resistance was 12% by Etest and 10.6% by agar dilution. Amoxicillin or tetracycline resistance was rare. Metronidazole and clarithromycin resistance was more common in women than men (eg, 34.7% vs 22.6% for metronidazole and 14.1% vs 9.7% for clarithromycin (P =.01 and P =.06, respectively). Antibiotic resistance increased gradually up to age 70 years, then declined significantly (P<.05) regardless of test method. Regional differences in antimicrobial resistance did not occur. CONCLUSIONS: While age and sex had significant effects on resistance rates, regional differences were not present. The high prevalence of resistance to metronidazole and clarithromycin may soon require the performance of antimicrobial susceptibility testing of H pylori isolates prior to initiating treatment.  相似文献   

15.
BACKGROUND: Pretreatment antimicrobial resistance has an important impact on the efficacy of many Helicobacter pylori treatment regimens. OBJECTIVE: To estimate the prevalence of H. pylori resistance to antimicrobials in the United States, to characterize risk factors associated with H. pylori antimicrobial resistance, and to explore the association between drug utilization and antimicrobial resistance patterns over time. DESIGN: Meta-analysis using patient-level data. SETTING: 20 nationwide trials of H. pylori eradication. PATIENTS: 3624 men and women, each of whom contributed one isolate. MEASUREMENTS: Rates of H. pylori resistance to clarithromycin, metronidazole, and amoxicillin, according to geographic region, age, sex, study year, ethnicity, ulcer status, test method, and study. RESULTS: Overall resistance to clarithromycin, metronidazole, and amoxicillin was 10.1% (95% CI, 9.1% to 11.1% [360 of 3571 patients]), 36.9% (CI, 35.1% to 38.7% [1063 of 2883 patients]), and 1.4% (CI, 1.0% to 1.8% [48 of 3486 patients]), respectively. In multivariable analyses, multiple risk factors were associated with resistance to individual agents. Clarithromycin resistance was significantly associated with geographic region (P = 0.050), older age (P < 0.001), female sex (P < 0.001), inactive ulcer disease (P < 0.001), and study (P = 0.010). Metronidazole resistance was significantly associated with female sex (P < 0.001), earlier year of study enrollment (P = 0.036), Asian ethnicity (P < 0.001), use of an epsilometer test (P = 0.002), and study (P < 0.001). Amoxicillin resistance was low and was not significantly associated with any risk factor. In the 1990s, when rates for use of oral macrolides and metronidazole were relatively stable, clarithromycin resistance rates were stable and metronidazole resistance rates varied. CONCLUSIONS: Clinicians should consider risk factors for antimicrobial resistance when deciding which patients should have susceptibility testing and when choosing appropriate H. pylori treatments in the empirical setting.  相似文献   

16.
The efficacy of first-and second-line Helicobacter pylori(H.pylori)eradication regimens varies considerably in West Asian countries,mainly due to the variable prevalence of resistant organisms.However,no review article has yet evaluated and compared the efficacy of different regimens among different countries of this region.Therefore,we conducted a review to select the best options and provide recommendations for H.pylori treatment in this geographic region.A search through PubMed was carried out to obtain relevant randomized clinical trials published in English language up to June2013.According to the results,among different therapeutic regimens used as the first-line protocols,10-d Bismuth-Furazolidone/Metronidazole quadruple therapy,14-d Clarithromycin-containing hybrid therapy and 14-d quadruple therapy including a proton pump inhibitor +Bismuth+Tetracycline(500 mg QID)+Metronidazole(500 mg TDS)seemed to be appropriate options.Among second-line therapeutic regimens,Bismuthbased quadruple therapies containing Tetracycline and Furazolidone/Metronidazole,triple therapy containing Amoxicillin and Gatifloxacin and Quadruple therapy including Bismuth+Azithromycin and Ofloxacin seemed to be effective options.Third-line therapies were not evaluated in West Asia;most guidelines,however,recommend choosing optimal eradication regimen according to the pattern of antibiotic susceptibility of H.pylori.Although we limited our investigation to H.pylori eradication regimens in West Asia,the clinical significance of the results goes beyond the countries situated in this geographic region.In fact,the results are transferrable to any region as long as the patterns of resistance are the same.  相似文献   

17.
雷贝拉唑三联疗法治疗消化性溃疡66例疗效观察   总被引:1,自引:0,他引:1  
126例消化性溃疡患者随机分成对照组60例应用雷贝拉唑10mg qd,疗程4周;治疗组66例应用雷贝拉唑10mg qd,疗程4周,阿莫西林0.75g tid、克托霉素0.5g bid,疗程1周。两组溃疡愈合率均达100%;治疗组H.pylori清除率95.5%,对照组25%;随诊所有患者2月、1年溃疡复发率,治疗组分别为6.7%、9.1%,对照组分别为33.3%、58.3%;无药物不良反应。结果表明雷贝拉唑三联疗法疗程短、高效、依从性好,无药物副作用,使用方便,溃疡复发率低。  相似文献   

18.
Pseudomembranous colitis after Helicobacter pylori eradication therapy   总被引:1,自引:0,他引:1  
A 69-year-old woman with gastritis was prescribed a 1-week triple regimen therapy of Amoxicillin, Clarithromycin, and Lansoprazole to eradicate Helicobacter pylori (H. pylori) starting on March 7, 2005. H. pylori was detected on the gastric mucosa by the urease test. Twenty days after eradication therapy, she began to suffer from profuse watery diarrhea. Colonoscopy on April 12 showed multiple pseudomembranes in the cecum and the transverse colon, leading to a diagnosis of pseudomembranous colitis. Because she had not taken Vancomycin (VCM) (500 mg/day) as directed, she had a relapse of watery diarrhea and was admitted on April 30. A stool test for Clostridium difficile (CD) toxin was positive, although colonoscopy showed only a few aphthoid erosions in the cecum and the transverse colon on May 6. She was treated with oral VCM (2000 mg/day) from May 6, and diarrhea disappeared by May 11. The stool test for CD toxin was negative, so VCM was discontinued. Care must thus be taken in H. pylori eradication to ensure that the triple regimen therapy does not lead to pseudomembranous colitis.  相似文献   

19.
Background/aimsAntibiotic resistance and poor compliance are the main causes of Helicobacter pylori (H. pylori ) eradication failure. This study evaluated the eradication rate, tolerability, and compliance of Levofloxacin, Clarithromycin and Esomeprazol combined triple therapy for H. pylori eradication.Patients and methodsFour hundred-fifty patients from 3 centres who were diagnosed to have Helicobacter pylori infection by 13C-urea breath test were randomized into 3 equal groups; group 1 (CAE) received Clarithromycin 500 mg twice daily, Amoxicillin 1000 mg twice daily, plus Esomeprazol 20 mg twice daily for 7 days, group 2 (LAE) received Levofloxacin 500 mg once daily, Amoxicillin 1000 mg twice daily, plus Esomeprazol 20 mg twice daily for 7 days, group 3 (CLE) received Levofloxacin 500 mg once daily, Clarithromycin 500 mg twice daily, plus Esomeprazol 20 mg twice daily for 7 days. 436 patients were re-evaluated by 13C-urea breath test after 6 weeks from completion of treatment.ResultsH. pylori eradication (intention to treat) was successful in 136/150 (90.6%) with CLE, 127/150 (84.7%) with LAE and 118/150 (78.6%) with CAE. There was a significant difference (p < 0.001) regarding treatment success between CLE and LAE when compared with CAE. There was no difference among the treatment groups with regard to the incidence and severity of adverse events reported.ConclusionThe combined Levofloxacin, and Clarithromycin and Esomeprazol based regimen as first line triple therapy for H. pylori eradication can give more significant eradication rate with same safety when compared with classic triple therapy.  相似文献   

20.
目的体外观察温州地区儿童幽门螺杆菌(Hp)菌株对临床常用8种抗生素的耐药性及其与细胞毒素相关蛋白(CagA)的关系。方法对分离的的41株Hp行药物敏感试验,并用免疫印迹法检测患儿血清Cag,a抗体。结果CagA阳性Hp菌株中替硝唑、克拉霉素、呋喃唑酮、羟氨苄青霉素、阿齐霉素、庆大霉素、诺氟沙星和头孢哌酮耐药菌株分别为100.0%、55.6%、48.3%、38.7%、32.3%、32.3%、25.8%和0.0%,而在Ca舭阴性Hp菌株中耐药菌株分别为90.0%、50.0%、40.0%、50.0%、30.0%、20.0%、0.0%和0.0%,两组差异无统计学意义。结论该地区儿童耐药Hp菌株多见,其耐药性与CagA无明显相关。  相似文献   

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