海岛地区就医患者幽门螺杆菌对常用抗生素的耐药特点分析  

Resistance of Helicobacter pylori to commonly used antibiotics in patients of island regions

作　　者：汤武亨[1] 曹春宇[1] 金海[1] 李松财 陈国光[1] 

机构地区：[1]浙江省舟山市第三人民医院消化内科,浙江舟山316000

出　　处：《疾病监测》2008年第12期748-749,共2页Disease Surveillance

摘　　要：目的探讨幽门螺杆菌(Helicobacter pylori,Hp)对海岛地区常用抗生素的耐药特点,并根据本地区特点指导选择最特异最合适的抗生素进行治疗。方法将来自不同患者的胃镜活检标本分别涂布接种幽门螺杆菌培养基后37℃微需氧环境下培养96h,对188株Hp临床分离株采用Kirby-Bauer法行甲硝唑、克拉霉素、阿莫西林、呋喃唑酮和左氧氟沙星5种抗生素药敏试验,并分析其特点。结果Hp临床分离株对甲硝唑、克拉霉素、阿莫西林、呋喃唑酮和左氧氟沙星5种抗生素的耐药率分别为98.9%,18.1%,0.1%,8.5%和7.8%。舟山各区县和城乡之间对常用抗生素耐药率比较差异无统计学意义。结论甲硝唑耐药率均较高,可用呋喃唑酮替代甲硝唑,左氧氟沙星也可以选择;应注意对本地克拉霉素耐药的监测;根据体外药敏试验有利于提高Hp的根除率。Objective This study was designed to investigate the antibiotic resistance of Helicobacter priori （Hp） in patients of island regions, provide the evidence for the most specific antibiotic treatment. Methods Gastroscopic samples from various patients were cultured on Hp mediums, incubated at 37 ℃ for 96 h under aerobic micro-environment. Antibiotic sensitivity test was conducted in 188 Hp clinical isolates by using Kirby- Bauer method to detect the resistance to metronidazole, clarithromycin, amoxicillin, furazolidone and ofloxacin. Results The resistance rates of clinical isolates to metronidazole, clarithromycin, amoxicillin, furazolidone and levofloxacin were 98.9%, 18.1%, 0.1%, 8.5% and 7.8%, respectively. No statistical differences were found on the resistance of isolates between districts and counties, urban area and rural area in Zhoushan. Conclusion Given high resistance rate to metronidazole, furazolidone and levofloxacin can be used as alternative. Resistance of local isolates to clarithromycin shall be supervised. In vitro drug sensitivity test will help to improve the eradication rate of hip.

关 键 词：幽门螺杆菌 耐药 幽门螺杆菌根除 

分 类 号：R573[医药卫生—消化系统]