幽门螺杆菌相关萎缩性胃炎的区域耐药性分析  

Analysis of regional drug resistance in H.pylori-related atrophic gastritis

作　　者：贺新国 郭保根 HE Xin-guo;GUO Bao-gen(Departmentof GI Medicine,Shuangliu District Traditional Chinese Medicine Hospital of Chengdu,Chengdu 610020,Sichuan,CHINA)

机构地区：[1]成都市双流区中医医院消化内科,四川成都610020

出　　处：《海南医学》2021年第5期571-573,共3页Hainan Medical Journal

基　　金：四川省成都市卫计委医学科研课题立项(编号:16PJ096)。

摘　　要：目的观察幽门螺杆菌(HP)相关萎缩性胃炎对常用抗生素的耐药性,并就克拉霉素、左氧氟沙星耐药菌株的耐药基突变点位进行分析,为临床治疗Hp相关萎缩性胃炎敏感抗生素的选择提供参考。方法选取2019年6月至2020年6月在成都市双流区中医医院消化内科经胃镜检查确诊的Hp相关萎缩性胃炎患者210例,分离菌株,用体外药敏试验观察其对常用抗生素的耐药性,采用RT-PCR法检测Hp23s rRNA基因V区A2142G、A2143G突变和gyrA基因N87K(C261A)、D91N(G271A)突变。结果对分离的200株菌株进行7种常用抗生素的药敏试验,甲硝唑耐药140株(70.0%),左氧氟沙星耐药77株(38.5%),克拉霉素耐药31株(15.5%),阿莫西林耐药20株(10.0%),呋喃唑酮、庆大霉素和四环素耐药各2株(1.0%);N87K(C261A)突变耐药菌株15株,敏感组0株,差异具有统计学意义(P<0.05);D91N(G271A)突变耐药菌株13株,敏感组0株,差异具有统计学意义(P<0.05);A2142G突变耐药菌株17株,敏感菌株2株,差异具有统计学意义(P<0.05);A2143G突变耐药菌株13株,敏感菌株1株,差异具有统计学意义(P<0.05);T2182C突变耐药菌株15株,敏感菌株4株,差异无统计学意义(P>0.05)。结论本地区分离的HP耐药菌株中,对克拉霉素耐药率最高的以23S r RNA基因V区中的A2143G位点突变为主,对左氧氟沙星耐药率最高的以gyrA基因C261A、G271A位点突变为主。Objective To observe the resistance of H.pylori-related atrophic gastritis to commonly used antibiotics,and analyze the mutation points of the drug-resistant gene of clarithromycin and levofloxacin-resistant strains for clinical,so as to provide references for the selection of sensitive antibiotics for the treatment of HP-related atrophic gastritis.Methods A total of 210 patients with HP-related atrophic gastritis,diagnosed by gastroscopy in Department of GI Medicine,Shuangliu District Traditional Chinese Medicine Hospital of Chengdu from June 2019 to June 2020 were selected as the research subjects.The strains were isolated,the resistance to commonly used antibiotics was observed by in vitro drug sensitivity test,and RT-PCR was used to detect the mutations of A2142 G and A2143 G in the V region of Hp23 s rRNA gene and the mutations of N87 K(C261 A)and D91 N(G271 A)of the gyrA gene.Results A total of 200 isolated strains were tested for susceptibility to 7 commonly used antibiotics.Among of which,140 strains were resistant to metronidazole(70.0%),77 strains were resistant to levofloxacin(38.5%),and 31 strains were resistant to clarithromycin(15.5%),20 strains(10.0%)were resistant to amoxicillin,and 2 strains(1.0%)were resistant to furazolidone,gentamicin and tetracycline,respectivley.There were 15 strains of N87 K(C261 A)mutant resistant strains and 0 strains in the sensitive group,the difference was statistically significant(P<0.05);there were 13 strains of D91 N(G271 A)mutant resistant strains and 0 sensitive strains,and the difference was statistically significant(P<0.05);there were 17 strains of A2142 G mutant resistant strains,2 strains of sensitive strains,and the difference was statistically significant(P<0.05);there were 13 strains of A2143 G mutant resistant strains,1 strain of sensitive strains,and the difference was statistically significant(P<0.05);there were 15 strains of T2182 C mutation resistant strains,4 strains of sensitive strains,and the difference was not statistically significant(P>0.05).Con

关 键 词：H.pylori相关萎缩性胃炎 耐药 点突变 23s rRNA基因 GYRA基因 

分 类 号：R573.3[医药卫生—消化系统]