上消化道疾病患者幽门螺杆菌的感染率及耐药性

目的 了解西安地区胃肠疾病患幽门螺杆菌的感染率及对常用抗菌素的敏感性，为幽门螺杆感染治疗的药物选择提供依据。方法 采用细菌培养的方法对259例胃肠疾病患胃粘膜活检标本进行了幽门螺杆分离鉴定，并用琼脂稀释和浓度梯度法对随机抽取的50株幽门螺杆菌进行了抗生素敏感性试验。结果 西安地区胃肠疾病患幽门螺杆菌的感染率为74%，其中胃癌的感染率为58%；胃溃疡的感染率为75%；十二脂肠溃疡的感染率为95%；其他胃肠疾病也有不同的感染率，幽门螺杆菌对阿莫西林和克拉霉素的敏感率均为100%，两种检测方法无差异。幽门螺杆菌对甲硝唑的耐药率较高，琼脂稀释法为38%，浓度梯度法为58%，存在一定的差异。结论 幽门螺杆菌是胃肠疾病发生的重要因素，在西安地区阿莫西林和克拉霉素是治疗幽门螺杆菌感染的首选药物，控制甲硝唑在治疗幽门螺杆菌感染中的使用。在进行幽门螺杆菌对甲硝唑的敏感试验时，应采取琼脂稀释和浓度梯度两种方法，以提高耐药菌的检出。

Study on infection rate and resistance of Helicobacter pylori from patients with gastroenteric disease

AIM To investigate infection rate and resistance to common drugs of Helicobacter pylori(Hp) of patients with upper diseases in Xi'an area. METHODS Hp in gastric biopsy specimens from 259 patients with gastroenteric diseases was studied by bacterial culture method. In vitro , antimicrobial susceptibility of 50 strains Hp of random selection was tested by E test and agar dilution method. RESULTS Hp infection rate in patients with gastroenteric diseases was 74% inXi'an area. The detection rates of Hp in patients with gastric cancer, gastric ulcer, duodenal ulcer were 58%,76% and95% respectively. Susceptibility rate of Hp to amoxicillinand clarithromycin was 100%. Hp was highly resistant to metronidazole, and its resistance rate was found to be 38% by agar dilution method and 58% by E test method. CONCLUSION Hp directly leads to gastroenteric diseases. Amoxicillin and clarithromycin are first choice drugs for treatment of Hp infection,but metronidazole is not usually used in Xi'an area. In susceptibility testing of Hp to metronidazole, both E test method and agar dilution method are recommended.