青岛地区幽门螺杆菌对左氧氟沙星耐药性及gyrA基因突变分析  

Analysis of the levofloxacin resistance and gyrA gene mutation of Helicobacter pylori in Qingdao

作　　者：王松松[1] 苏艳华[1,2] 战淑慧 董全江 张建立[1] 

机构地区：[1]青岛大学医学院,山东青岛266071 [2]青岛市立医院中心实验室和消化科

出　　处：《胃肠病学和肝病学杂志》2013年第5期428-430,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的分析青岛地区幽门螺杆菌(H.pylori)对左氧氟沙星的耐药现状,探讨H.pylori对左氧氟沙星耐药性与gyrA基因突变之间的关系。方法收集胃癌及胃炎患者的胃窦部黏膜标本,分离培养H.pylori,采用E-test法测定H.pylori对左氧氟沙星的最低抑菌浓度(MIC),提取H.pylori基因组DNA,PCR法扩增gyrA基因片段并对扩增产物测序、分析。结果从患者胃黏膜中成功分离出65例H.pylori菌株,23例对左氧氟沙星耐药(MIC>1μg/ml),占总菌株的35.4%,所有耐药菌株gyrA基因中的喹诺酮类耐药决定区(QRDR)都存在突变位点,且以第87位点的氨基酸发生突变为主,而敏感菌株中未发现基因突变位点。结论青岛地区H.pylori对左氧氟沙星的耐药率高于国内其他地区,表明gyrA基因突变是导致H.pylori对左氧氟沙星耐药的主要原因。Objective To analyze the prevalence of Helicobacter pylori （H. pylori） strains resistance to levofloxacin and explore the relationship between gyrA genetic mutation and levofloxacin resistance. Methods Gastric mucosa were collected from patients with either gastric adenocarcinoma or gastritis, and inoculated in brain heart infusion （BHI） solid medium to isolate the H. pylori strains. Minimal inhibitory concentration （MIC） values of levofloxacin were determined by E-test. H. pylori gyrA gene was amplified by PCR and the sequences were analyzed. Results 65 H. pylori strains were isolated from the patients＇ mucosa, 23 （35.4%） cases were found resistant to levofloxacin （MIC 〉 1 μg/ml）, all the resistant strains had mutations in quinolone resistance-determining region （QRDR） of the gyrA gene. Mutations at position 87 were more frequent than others in resistant strains. However, no mutation positions were found in the sensi- tive strains. Conclusion The prevalence of H. pylori resistance to levofloxacin in Qingdao is higher significantly than other areas. The resistance primarily mediated through a variety of point mutations occurring in gyrA gene.

关 键 词：幽门螺杆菌 左氧氟沙星 耐药 GYRA 突变 

分 类 号：R57[医药卫生—消化系统]