HELICOBACTER：抗生素耐药增加限制Hp根除效果
2012-12-21 HELICOBACTER CMT 秋阳 翻译
韩国一项研究显示，幽门螺杆菌（Hp）的原发性、继发性抗生素耐药性增加，将显著降低Hp根除程度。研究12月13日在线刊登于《幽门螺杆菌》（Helicobacter）杂志。 研究结果显示，在2003-2012年间，347例未接受过任何根除治疗的Hp感染者，以及86例根除治疗失败后检出Hp的患者中，阿莫西林（6.3%~14.9%）、克拉霉素（17.2%~23.7%）、左氧氟沙星和莫西沙星（均为
韩国一项研究显示，幽门螺杆菌（Hp）的原发性、继发性抗生素耐药性增加，将显著降低Hp根除程度。研究12月13日在线刊登于《幽门螺杆菌》（Helicobacter）杂志。
研究结果显示，在2003-2012年间，347例未接受过任何根除治疗的Hp感染者，以及86例根除治疗失败后检出Hp的患者中，阿莫西林（6.3%~14.9%）、克拉霉素（17.2%~23.7%）、左氧氟沙星和莫西沙星（均为4.7%~28.1%）原发性耐药率升高。甲硝唑、左氧氟沙星和莫西沙星的继发性耐药率显著增加。克拉霉素、阿奇霉素、左氧氟沙星和莫西沙星的耐药性与此前的根除治疗史相关。
与幽门螺杆菌相关的拓展阅读：
- Lancet：幽门螺杆菌的新疗法，杀菌率九成以上
- PLoS ONE：感染幽门螺杆菌A型血者更易贫血
- JID：根除幽门螺杆菌可预防糖尿病？
- 幽门螺杆菌可增加患II型糖尿病风险
- 丁士刚：幽门螺杆菌（HP）与胃癌关系，从历史到未来 更多信息请点击：有关幽门螺杆菌更多资讯
Background
Antimicrobial resistance of Helicobacter pylori (H. pylori) affects the efficacy of eradication therapy. The aim of this study was to estimate the prevalence of primary and secondary resistance of H. pylori isolates to antibiotics and to characterize the risk factors associated with antimicrobial resistance in Korea.
Materials and Methods
This study was performed during the period of 2003–2012. Primary resistance was evaluated from 347 patients without any history of eradication, and secondary resistance was evaluated in 86 patients from whom H. pylori was cultured after failure of eradication. Minimal inhibitory concentration test was performed for amoxicillin, clarithromycin, metronidazole, tetracycline, azithromycin, levofloxacin, and moxifloxacin using agar dilution method. Primary and secondary resistance rates of H. pylori to 7 antibiotics were evaluated and risk factors for the antibiotic resistance were analyzed.
Results
Increase in the primary resistance rate was found in amoxicillin (6.3–14.9%, p = .051), clarithromycin (17.2–23.7%, p = .323), and both of levofloxacin and moxifloxacin (4.7–28.1%, p = .002) during the study period. Secondary resistance rate significantly increased in metronidazole, levofloxacin, and moxifloxacin. Increase of resistance occurred after initial failure of eradication therapy in case of clarithromycin (p < .001), azithromycin (p < .001), levofloxacin (p = .011), and moxifloxacin (p = .020). Multivariable analyses showed that clarithromycin, azithromycin, levofloxacin, and moxifloxacin resistance was associated with previous eradication treatment history.
Conclusions
The increased primary and secondary antibiotic resistance of H. pylori in Korea is ongoing, and it will become a significant limitation for effective eradication of H. pylori in the future.
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本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
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#根除#
50
#Helicobacter#
39
#抗生素耐药#
0