福建省边远海岛和城市地区幽门螺杆菌耐药菌株比较  

Comparison of antibiotic resistance of H. pylori between rural island and urban area in Fujian province

作　　者：阮华良[1] 毛文灏[1] 陈仁利[1] 陈明红[2] 吴芳[2] 付丹[2] 潘秀珍[2] 彭孝纬[2] 

机构地区：[1]福建省宁德市医院,宁德352100 [2]福建省立医院福建省胃肠病研究所

出　　处：《中原医刊》2007年第5期9-11,共3页Central Plains Medical Journal

基　　金：福建省科技厅重点项目资助（2003Y015）

摘　　要：目的 研究福建省边远海岛和城市地区幽门螺杆菌（却）的耐药状况，并比较城市地区2001—2006年Hp耐药状况的变化。方法 取Hp阳性者胃窦黏膜进行上Hp培养，对分离的幽门螺杆菌菌株进行药敏试验。用琼脂稀释法和临界点浓度法测定Hp对甲硝唑、克拉霉素和阿莫西林的敏感性。判定为耐药的标准：甲硝唑的最小抑菌浓度（MIC）〉18mg／L，克拉霉素的MIC值〉12mg／L，阿莫西林的MIC值〉10．5mg／L。结果 边远海岛地区Hp对甲硝唑的耐药率为11．4％，显著低于城市居民的55．6％（P〈0．01）；对克拉霉素的耐药率为5．7％，也显著低于城市居民的26．0％（P〈0．01）。城市居民Hp对甲硝唑的耐药率自2001年后明显升高，由34．0％上升至47．1％（p〈0．05）；Hp对克拉霉素的原发耐药率自2001年后也明显升高，由10．6％上升至29．4％（P〈0．01）。却对阿莫西林的耐药极少。2004年以前未发现Hp对阿莫西林的耐药菌株，但2006年发现有2株Hp对阿莫西林耐药，占2％（2／102）。结论 边远海岛地区Hp对甲硝唑和克拉霉素的耐药率显著低于城市地区，城市地区Hp对甲硝唑、克拉霉素和阿英西林的耐药2006年比2001年明显上升。Objective To investigate antibiotic resistance of H. pylori strains isolated from the rural island and the strains isolated from urban area and compare the resistance frequency of H. pylori strains in urban area between 2001 and 2006. Methods H. pylori strains were isolated form antrum biopsy specimens. The MICs of amoxicillin, clarthromycin and metronidazole were determined by agar dilution method and the E - test. The MIC breakpoint of amoxicillin,clarthromycin and metronidazole were set at 0. 5 μg/ml,2 μg/ml,8μg/ml,8μg/ml respectively. Results The prevalence of metronidazole resistance was 11.4% and the prevalence of clarthromycin resistance was 5.7% in the strains isolated from the island. No amoxicillin - resistance strain was found. Compared with the strains isolated from the island,the strains isolated from the urban area had a significantly higher rate of resistance to metronidazole and clathromycin （34% and 10. 6% respectively）. The antibiotic resistance of H. pylori strains to metronidazole was 47% in urban area in 2006,significantly higher than 34.0% in 2001 （ P 〈0.05）. The resistance rate of H. pylori strains to clathromycin was 29.4% in urban in 2006,significantly higher than 10.6% in 2001 （ P 〈 0.01 ）. No resistance of H. pylori strains to amoxicillin was found in 2001, but 2% of H. pylori strains were found to be resisted to amoxixillin in 2006. Conclusion The frequency of antibiotic resistance of H. pylori in rural aera is significantly lower than that in urban area. Antibiotic resistance of H. pylori strains raise up in urban area.

关 键 词：幽门螺杆菌 耐药 甲硝唑 克拉霉素 阿莫西林 

分 类 号：R446[医药卫生—诊断学]