湖州地区青少年儿童幽门螺杆菌感染及耐药情况  

The infection and antibiotic resistance of Helicobacter pylori in children and adolescents in Huzhou,Zhejiang

作　　者：丁建[1] 钟婧[2] 钮萍萍 施杰民[1] 张军[1] 戴利成[2] 徐震[3] 

机构地区：[1]浙江省湖州市中心医院消化内科,313000 [2]浙江省湖州市中心医院分子医学重点实验室,313000 [3]浙江省湖州市中心医院儿科,313000

出　　处：《国际流行病学传染病学杂志》2017年第6期378-381,共4页International Journal of Epidemiology and Infectious Disease

基　　金：浙江省公益性技术应用研究计划项目（2013C33110）

摘　　要：目的 了解浙江省湖州地区青少年儿童幽门螺杆菌（HP）感染及耐药情况.方法 对2014年1月至2017年6月在湖州市中心医院就诊的391例10～18岁主诉有上消化道不适症状的患儿行胃镜检查,采集胃黏膜样本进行HP分离培养,并用平板掺入法对HP进行药敏试验.结果 391例患儿胃黏膜样本中HP的分离培养阳性率为27.37％（107例）,十二指肠溃疡患儿HP阳性率显著高于慢性胃炎患儿（67.24％：20.42％,x2=54.479,P＜0.01）. 107株HP对克拉霉素的平均耐药率为22.43％（24株）,甲硝唑为73.83％（79株）,左氧氟沙星为11.82％（13株）,没有发现对阿莫西林、呋喃唑酮和四环素耐药的菌株.15～18岁青少年对克拉霉素的耐药率显著高于10～14岁儿童（29.73％：6.06％,x2=6.051,P＜0.05）.结论 本地区青少年儿童对克拉霉素和甲硝唑均有非常高的耐药率,应重视菌株的分离培养和耐药性检测,临床应考虑儿童和青少年的耐药性差异.Objective To investigate the prevalence of H.pylori （HP） infection and antibiotic resistance in symptomatic children and adolescents in Huzhou,Zhejiang.Methods HP strains were isolated from gastric mucosa biopsy specimens collected from 391 symptomatic children and adolescents at the age of 10-18 years old in Huzhou Central Hospital from January 2014 to June 2017.Plate incorporation method was used to determine drug sensitivity.Results There were 107 （27.37％） HP strains isolated from 391 gastric mucosa biopsy specimens.The positive rate of HP in children and adolescents with duodenal ulcer was significantly higher than that in ones with chronic gastritis （67.24％ ∶ 20.42％,x2=54.479,P＜0.01）.The resistance rates of 107 HP strains to clarithromycin,metronidazole and levofloxacin were 22.43％ （24 stains）,73.83％ （79 strains） and 11.82％ （13 strains）,respectively.No strain was resistant to amoxicillin,furazolidone or tetracycline.The resistance rate to clarithromycin among adolescents between 15 and 18 years old was obviously higher than that among children between 10 and 14 years old （29.73％ ∶ 6.06％,x2 =6.051,P＜0.05）.Conclusions The resistance rates to clarithromycin and metronidazole in children and adolescents in Huzhou are very high.The isolated culture and antibiotic susceptibility testing of HP should be paid attention.The different antibiotic resistance rates with different ages should be considered during clinical treatment.

关 键 词：螺杆菌 幽门 耐药 儿童 青少年 治疗 

分 类 号：R725.7[医药卫生—儿科]