浙江金华地区幽门螺杆菌耐药性和耐药基因突变位点分析  

Analysis on antibiotic resistance and related gene mutations of Helicobacter pylori in Jinhua area, Zhe-jiang

作　　者：刘颖[1] 朱以军[1] 王月[1] 黄彩群 Liu Ying;Zhu Yijun;Wang Yue;Huang Caiqun(Department of Central Laboratory,Jinhua Central Hospital,Jinhua 321000,Zhejiaug,China)

机构地区：[1]金华市中心医院中心实验室,浙江金华321000

出　　处：《国际流行病学传染病学杂志》2018年第4期242-245,共4页International Journal of Epidemiology and Infectious Disease

基　　金：金华市科技计划重点项目（2017-3-015）;金华市中心医院重点项目（JY2016-1-03）

摘　　要：目的了解金华地区幽门螺杆菌（Hp）对临床常用抗生素的耐药性，探讨Hp对克拉霉素和左氧氟沙星相关耐药基因突变和分布情况。方法收集2016年1—12月金华市中心医院胃镜样本中分离到的398株Hp菌株，采用体外药敏试验，分析其对7种抗生素的耐药性；同时采用测序技术检测Hp对克拉霉素和左氧氟沙星的相关耐药基因。结果398株Hp菌株对甲硝唑耐药率最高（80．15％），其次为左氧氟沙星（38．69％）和克拉霉素（12．56％），未检测到呋喃唑酮、阿莫西林、庆大霉素和四环素耐药菌株；全敏感70株（17．59％），单药耐药163株（40．95％），双重耐药135株（33．92％），三联耐药30株（7．54％）。本地区Hp对克拉霉素相关的耐药基因23SrRNAV区的耐药突变位点为A2143G；对左氧氟沙星相关耐药基因gyrA的氨基酸突变方式为N87K和D91FI／G／N／Y。结论金华地区Hp对甲硝唑、左氧氟沙星和克拉霉素耐药率较高。本地区Hp对克拉霉素耐药基因突变位点主要为23SrRNAV区基因的2[43位点；对左氧氟沙星耐药基因突变位点的氨基酸突变方式主要为∥一基因的87和91位点。Objective To analyze the antibiotic resistance of Helicobacter pylori （Hp） to common clinical antibiotics in Jinhua area, and explore the mutation and distribution of clarithromycin and levofloxacin resistance genes. Methods A total of 398 Hp strains were isolated from gastroscope samples during January to December 2016 in Jinhua Central Hospital. The resistance of these strains to 7 antibiotics was analyzed in vitro. Meanwhile, the related genes which was resistant to levofloxacin and clarithromycin were determined by gene sequencing. Results Of the 398 Hp strains, the resistance rates to metronidazole, levofloxacin, clarithromycin were 80.15%, 38.69% and 12.56%, respectively. No strain was resistant to furazolidone, amoxicillin, gentamicin or tetracycline. There were 70 （17.59%） Hp strains susceptible to all tested antibiotics, 163 （40.95%） mono-, 135 （33.92%） double- and 30 （7.54%） triple-drug resistant strains. The clarithromycin resistance gene mutation loci was A2143G in 23S rRNA V gene. Meanwhile the amino acid mutations of levofloxacin resistance gene gyrA were N87K and D91H/G/N/Y. Conclusions Hp resistance to metronidazole, levofloxacin and clarithromycin are high in Jinhua area of Zhejiang. The clarithromycin resistance gene mutation loci is 2143 gene loci of 23S rRNA V and the levofloxacin resistance gene mutation is 87 and 91 gene loci of gyrA in this area.

关 键 词：螺杆菌 幽门 耐药性 基因突变 

分 类 号：R521[医药卫生—内科学]