贵州省幽门螺杆菌临床菌株的抗生素耐药现状

目的检测贵州省幽门螺杆菌(Helicobacter pylori,H.pylori)临床菌株对多种抗生素的耐药率,并分析甲硝唑(MTZ)、克拉霉素(CLA)、阿莫西林(AMO)耐药菌株的临床特征。方法以贵州地区30株培养成功的H.pylori临床菌株为研究对象,采用Kirby-Bauer及E-test法测定菌株对MTZ、CLA、AMO等多种抗生素的耐药性。分析MTZ、CLA、AMO耐药菌株与敏感菌株患者性别、年龄及疾病种类的差异。结果 Kirby-Bauer法显示H.pylori临床菌株对AMO、左氧氟沙星、庆大霉素、CLA、四环素、头孢呋肟、复方新诺明的耐药率分别为20.00%、3.33%、13.33%、30.00%、6.67%、0、0;E-test法显示H.pylori临床菌株对MTZ、AMO、CLA耐药率分别为63.33%、26.67%、33.33%;两种检查方法检测结果无明显差异;男性患者MTZ的耐药率(77.78%)较女性患者(41.67%)高(P<0.05);30～60岁年龄组患者MTZ的耐药率更高(P<0.05);CLA和AMO的耐药率与疾病种类、性别、年龄无明显关系(P>0.05)。结论贵州地区H.pylori临床菌株的耐药现状不容忽视,以男性消化性溃疡患者年龄在30～60岁对MTZ的耐药率较高。

Antibiotic resistance of Helicobacter pylori in Guizhou Province

Objective To determine the Helicobacter pylori(H.pylori) resistance to multiple antibiotics and the clinical features of antibiotic-resistance patients.Methods 30 H.pylori strains were successfully isolated.Resistance to different antibiotics,including clarithromycin(CLA),amoxicillin(AMO) and metronidazole(MTZ) were determined by Kirby-Bauer and E-test methods.Information of clinical features was gathered.Results Kirby-Bauer results showed 20.00%,3.33%,13.33%,30.00%,6.67%,0,0 of the strains were resistant to AMO,levofloxcin,gentamicin,CLA,tetracycline,cefuroxime or SMZ-TMP respectively.E-test results manifested that 63.33%,26.67%,33.33% of the strains were resistant to MTZ,AMO or CLA respectively.The resistance rate of H.pylori to MTZ in male patients(77.78%) was higher than that in female patients(41.67%)(P<0.05).The resistance rate of H.pylori to MTZ in patients with peptic ulcer(84.62%) was higher than that in patients with erosive gastritis(27.27%)(P<0.05).Patients aged 30~60 years old had a higher resistance rate to MTZ than other groups(P>0.05).There was no significant difference in CLA and AMO resistance rate among sex ages or disease.Conclusion Resistance of H.pylori to antibodies should be pay more concern in Guizhou province.Resistant rate of H.pylori to MTZ is the highest compared with other antibodies,especially in male patients with peptic ulcer around 30~60 ages.