陕西地区武警官兵幽门螺杆菌感染及抗生素耐药情况分析  

Investigation and analysis of infection and antibiotic resistance of Helicobacter pylori in armed policemen in Shaanxi province

作　　者：顾勇[1] 杨艳 陈星如[1] 李娜[1] 孟宏涛[1] GU Yong;YANG Yan;CHEN Xing-ru;LI Na;MENG Hong-tao(Department of Digestive System,Shaanxi Provincial Crops Hospital of Chinese People’s Armed Police Force,Xi’an 710054,China;Fourth Department,Xijing Hospital of Digestive Diseases,Air Force Medical University,Xi’an 710032,China)

机构地区：[1]武警陕西总队医院消化内科,西安710054 [2]空军军医大学西京消化病医院四科,西安710032

出　　处：《解放军医学杂志》2019年第11期968-972,共5页Medical Journal of Chinese People's Liberation Army

摘　　要：目的调查分析陕西地区武警官兵幽门螺杆菌(Hp)感染及抗生素耐药情况,为武警官兵Hp根除治疗的合理用药提供理论依据。方法选取2016年6月-2017年12月于武警陕西总队医院行胃镜检查的武警官兵203例,收集胃镜活检标本,行Hp分离培养和鉴定。采用平板掺入法进行药敏试验,分析其对阿莫西林、克拉霉素、左氧氟沙星、甲硝唑等的耐药情况。结果胃镜活检标本分离培养Hp共获得阳性菌株119株,阳性率58.6%。消化性溃疡患者的Hp分离培养阳性率58.1%(36/62)明显高于慢性胃炎患者[35.2%(32/91),χ^2=7.832,P=0.005],与其他不同病理类型疾病相比,差异无统计学意义(P>0.05)。Hp对阿莫西林、克拉霉素、左氧氟沙星、甲硝唑的耐药率分别为1.7%(2/119)、10.1%(12/119)、14.3%(17/119)、28.6%(34/119),对两种药物同时耐药的菌珠有12株,其中7株对克拉霉素和甲硝唑同时耐药,5株对左氧氟沙星和克拉霉素同时耐药,未发现对3种及以上抗生素同时耐药的菌株。Hp耐药性在不同病理类型疾病间差异无统计学意义(P>0.05)。结论 Hp在陕西地区武警官兵消化性溃疡发生发展中发挥作用,根除治疗可采用一线治疗方案。Objective To investigate and analyze the situation of Helicobacter pylori(Hp) infection and antibiotic resistance in armed police officers and soldiers(APOSs) in Shaanxi province, and provide a theoretical basis for the rational selection of drugs for the eradication of Hp in the armed police forces in this region. Methods Two hundred and three APOS patients from the Shaanxi Armed Police Corps Hospital who underwent gastroscopy for gastrointestinal symptoms from June 2016 to December 2017 were enrolled in this study. Biopsy samples were extracted by gastroscope and Hp was isolated, identified and cultured. Four types of antibiotics were used to analyze the sensitivity of resistance to drugs: amoxicillin, clarithromycin, levofloxacin and metronidazole. Results A total of 119 Hp strains were isolated from 203 endoscopic biopsies. The positivity rate was 58.6%. The positivity rate of Hp isolation and culture in patients with peptic ulcer was 58.1%(36/62), which was significantly higher than that in patients with chronic gastritis(35.2%, 32/91, χ^2=7.832, P=0.005);There was no statistical difference compared with other pathological types of diseases(P>0.05). The resistance rates of Hp to amoxicillin, clarithromycin, levofloxacin, and metronidazole were 1.7%(2/119), 10.1%(12/119), 14.3%(17/119) and 28.6%(34/119), respectively. There were 12 of 119 strains were detected to be resistant to two drugs, of them 7 were resistant to clarithromycin and metronidazole, and 5 were resistant to levofloxacin and clarithromycin. We did not find the strains which are antibiotic resistant to three or more drugs. There was no significant difference in Hp resistance between different pathological disease types(P>0.05). Conclusions The role of Hp in the development of peptic ulcers among local armed police officers is very important. The current first-line therapy should be selected for eradication treatment of APOS patients in the region.

关 键 词：幽门螺杆菌 军人 耐药性 药敏试验 

分 类 号：R656.62[医药卫生—外科学]