|
|
|
| Analysis of the secondary resistance in Helicobacter pylori |
| LIUFU Junye LI Junda HU Guihua SHEN Jian′gang HUANG Jinwen QIU Jiahua FU Zhaoxia |
| Department of Gastroenterology, the Longhua District People′ Hospital of Shenzhen City, Guangdong Province, Shenzhen 518109, China |
|
|
|
Abstract Objective To investigate the secondary drug resistance of Helicobacter pylori (Hp) to six commonly used antibiotics, and to provid a basis for clinicians to rationally choose antibiotics and rationally formulate remedial plans for eradication of Hp. Methods A total of 120 patients with positive 13C breath test after Hp eradication were randomly selected from the Longhua District People′ Hospital of Shenzhen City. Gastroscopy was performed on the mucosa of the gastric antrum and on the minor curvature of the gastric body for Hp isolation and culture. The obtained Hp strain was tested for the drug sensitivity of Amoxicillin, Clarithromycin, Furazolidone, Doxycycline, Levofloxacin, Metronidazole. Results A total of 97 strains of Hp were successfully isolated and cultured, and those who were positive for the rapid urease test were successfully cultured. The positive rate of Hp culture were not related to gender, age, and 13C-urea breath test (P ＞ 0.05). The secondary drug resistance rates of Hp to Metronidazole, Amoxicillin, Clarithromycin and Furazolidone were 100.0%, 75.2%, 30.9%, and 1.0%, respectively. No strains resistant to Doxycycline or Levofloxacin were detected; the single drug resistance rate was 14.4%, the dual drug resistance rate was 65.0%, the triple drug resistance rate was 19.6%, while the quadruple drug resistance rate was 1.0%. Hp secondary resistance rates were not related to gender, age, and 13C-urea breath test results (P ＞ 0.05). Conclusion The remediation eradication of Hp should be individualized eradication treatment under the guidance of drug susceptibility test. Positive urease test is a reliable method to increase the positive rate of Hp culture.
|
|
|
|
|
|
[1] 中华医学会消化病学分会幽门螺杆菌学组.全国幽门螺杆菌研究协作组.第四次全国幽门螺杆菌感染处理共识报告[J].中华内科杂志，2012，51（10）：832-837.
[2] O′Connor A，Vaira D，Gisbert JP，et al. Treatment of Helicobacter pylori Infection 2014 [J]. Helicobacter，2015，19（s1）：38-45.
[3] Papastergiou V，Georgopoulos SD，Karatapanis S. Treatment of Helicobacter pylori infection：Meeting the challenge of antimicrobial resistance [J]. World J Gastroenterol，2014， 20（29）：9898.
[4] Maev IV，Kucheriavyǐ IuA，Andreev DN，et al. Eradication therapy for Helicobacter pylori infection：review of world trends [J]. Ter Arkh，2014，86（3）：94-99.
[5] 季红莉，路琴，黄慧，等.老年患者幽门螺杆菌感染根除失败的原因[J].中华老年多器官疾病杂志，2019，18（1）：26-29.
[6] 佟思羽，赵诗蕙，付冬梅.健康体检人群13C和14C尿素呼气试验检测幽门螺杆菌感染对比分析[J].中国保健营养，2019，29（20）：276-277.
[7] CLSI. Performance Standards for Antimicrobial Susceptibility Testing. 28th edition [M]. CLSI supplement M100.Wayne，PA：Clinical and Laboratory Standards Institute，2018.
[8] Sugano K，Tack J，Kuipers EJ，et al. Kyoto global consensus report on Helicobacter pylori gastritis [J]. Gut，2015， 64（9）：1353-1367.
[9] 中华医学会消化病学分会.中国慢性胃炎共识意见（2017年，上海）[J].中华消化杂志，2017，37（11）：721-738.
[10] Papastergiou V，Georgopoulos SD，Karatapanis S. Treatment of Helicobacter pylori infection：Meeting the challenge of antimicrobial resistance [J]. World J Gastroenterol，2014，20（29）：9898.
[11] 中华医学会消化病学分会幽门螺杆菌和消化性溃疡学组，全国幽门螺杆菌研究协作组.第五次全国幽门螺杆菌感染处理共识报告[J].中华内科杂志，2017，56（7）：532-545.
[12] Cui R，Zhou L. Helicobacter pylori infection：an overview in 2013，focus on therapy [J]. Chin Med J（Engl），2014， 127（3）：568-573.
[13] Zhang YX，Zhou LY，Song ZQ，et al. Primary antibiotic resistance of Helicobacter pylori strains isolated from patients with dyspeptic symptoms in Beijing：a prospective serial study [J]. World J Gastroenterol，2015，21（9）：2786-2792.
[14] Su P，Li Y，Li H，et al. Antibiotic resistance of Helicobacter pylori isolated in the Southeast Coastal Region of China [J]. Helicobacter，2013，18（4）：274-279.
[15] Bai P，Zhou LY，Xiao XM，et al. Susceptibility of Helicobacter pylori to antibiotics in Chinese patients [J]. J Dig Dis 2015，16（8）：464-470.
[16] Zhou L，Zhang J，Chen M，et al. A comparative study of sequential therapy and standard triple therapy for Helicobacter pylori infection：a randomized multicenter trial [J]. Am J Gastroenterol，2014，109（4）：535-541.
[17] Zhou L，Zhang J，Song Z，et al. Tailored versus Triple plus Bismuth or Concomitant Therapy as Initial Helicobacter pylori Treatment：A Randomized Trial [J]. Helicobacter，2016，21（2）：91-99.
[18] Song Z，Zhou L，Zhang J，et al. Hybrid Therapy as First-Line Regimen for Helicobacter pylori Eradication in Populations with High Antibiotic Resistance Rates [J]. Helicobacter，2016，21（5）：382-388.
[19] Zhang W，Chen Q，Liang X，et al. Bismuth，lansoprazole，amoxicillin and metronidazole or clarithromycin as first-line Helicobacter pylori therapy [J]. Gut，2015，64（11）：1715-1720.
[20] Xie C，Lu NH. Review：clinical management of Helicobacter pylori infection in China [J]. Helicobacter，2015，20（1）：1-10.
[21] Liang X，Xu X，Zheng Q，et al. Efficacy of bismuth-containing quadruple therapies for clarithromycin-，metronidazole-，and fluoroquinolone-resistant Helicobacter pylori infections in a prospective study [J]. Clin Gastroenterol Hepatol，2013，11（7）：802-807.
[22] Chen Q，Zhang W，Fu Q，et al. Rescue Therapy for Helicobacter pylori Eradication：A Randomized Non-Inferiority Trial of Amoxicillin or Tetracycline in Bismuth Quadruple Therapy [J]. Am J Gastroenterol，2016，111（12）：1736-1742.
[23] 崔俊华，李懿皞，周佳烨，等.幽门螺杆菌检测方法的发展与比较[J].检验医学，2018，33（1）：82-87.
[24] Atkinson NS，Braden B. Helicobacter Pylori Infection：Diagnostic Strategies in Primary Diagnosis and After Therapy [J]. Dig Dis Sci，2016，61（1）：19-24.
[25] Malfertheiner P，Megraud F，O′Morain CA，et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report [J]. Gut，2017，66：6-30. |
|
|
|
