氟喹诺酮类药物对幽门螺杆菌的防耐药变异浓度  

Mutant prevention concentrations of fluoroquinolones against Helicobacter pylori

作　　者：呼闯营[1] 柴晓哲[1] 周惠琴[2] 王少峰[1] 

机构地区：[1]苏州大学附属第二医院消化科,江苏省苏州市215004 [2]苏州大学附属第二医院检验科,江苏省苏州市215004

出　　处：《世界华人消化杂志》2010年第31期3347-3351,共5页World Chinese Journal of Digestology

摘　　要：目的:比较4种氟喹诺酮类药物对幽门螺杆菌(H.pylori)的防耐药变异浓度(MPC).方法:肉汤法富集1×1010CFU/mL的H.pylori临床分离菌16株,采用标准琼脂二倍稀释法测定4种氟喹诺酮类药物莫西沙星、加替沙星、左氧氟沙星和环丙沙星的最低抑菌浓度(MIC)、初测MPC(MPCpr),计算50%和90%菌株的MIC即MIC50和MIC90,计算90%菌株的MPC即MPCpr90,计算选择指数(MPCpr90/MIC90).结果:在16株H.pylori临床分离菌株中,莫西沙星、加替沙星、左氧氟沙星和环丙沙星对H.pylori耐药分别为2、1、4和2株.莫西沙星、加替沙星、左氧氟沙星和环丙沙星的H.pylori敏感菌株的MIC50分别为0.13、0.13、0.25和0.50mg/L,MIC90为0.50、0.50、1.00和0.50mg/L,MPCpr90为8.0、2.0、8.0和2.0mg/L,选择指数为16.0、4.0、8.0和4.0.结论:莫西沙星和加替沙星的抗H.pylori活性强于左氧氟沙星和环丙沙星,而加替沙星和环丙沙星限制H.pylori耐药突变株选择的能力优于左氧氟沙星和莫西沙星.AIM：To compare the mutant prevention concentrations（MPC） of four fluoroquinolones against fluoroquinolone-susceptible clinical Helicobacter pylori（H.pylori） isolates.METHODS：Sixteen clinical isolates of H.pylori were enriched in broth and adjusted to 1010 colony-forming units per milliliter.The minimal inhibitory concentration（MIC） and provisional MPC（MPCpr） of moxifloxacin,gatiloxacin,levofloxacin and ciprofloxacin were determined using the agar plate dilution method.The 50% MIC（MIC50）,90% MIC（MIC90）,and 90% provisional MPC（MPCpr90） for fluoroquinolone-susceptible H.pylori isolates were then calculated.RESULTS：When the breakpoints for fluoroquinolone resistance were defined as 1.0 mg/L,there were 2,1,4 and 2 H.pylori strains resistant to moxifloxacin,gatifloxacin,levofloxacin and ciprofloxacin,respectively.The MIC50 of moxifloxacin,gatifloxacin,levofloxacin and ciprofloxacin for fluoroquinolone-susceptible H.pylori isolates were 0.13,0.13,0.25 and 0.50,respectively,while the MIC90 were 0.50,0.50,1.00 and 0.50 mg/L,respectively.The MPCpr90 of moxifloxacin,gatifloxacin,levofloxacin and ciprofloxacin were 8.0,2.0,8.0 and 2.0 mg/L,and the ratios of MPCpr90 to MIC90 were 16.0,4.0,8.0 and 4.0,respectively.CONCLUSION：The anti-H.pylori activity of gatifloxacin and moxifloxacin might be stronger than that of levofloxacin and ciprofloxacin,and the capacity of gatifloxacin and ciprofloxacin restricting the selection of resistant mutants appears to be stronger than that of moxifloxacin and levofloxacin in the treatment of H.pylori infection.

关 键 词：氟喹诺酮药物 幽门螺杆菌 防耐药变异浓度 最低抑菌浓度 

分 类 号：R57[医药卫生—消化系统]