无锡某院幽门螺杆菌筛查人群感染流行病学及耐药性  

Epidemiological characteristics of Helicobacter pylori infection among screening population in a hospital of Wuxi and drug resistance

作　　者：钱君 张碧文 李佳 陈秀峰 王可 QIAN Jun;ZHANG Bi-wen;LI Jia;CHEN Xiu-feng;WANG Ke(Wuxi Second Hospital of Traditional Chinese Medicine,Wuxi,Jiangsu 214121,China)

机构地区：[1]无锡市第二中医医院脾胃病科,江苏无锡214121

出　　处：《中华医院感染学杂志》2022年第18期2794-2798,共5页Chinese Journal of Nosocomiology

基　　金：无锡市中医药管理局科技项目(ZYKJ202121)。

摘　　要：目的 探讨幽门螺杆菌感染的流行病学特点,为预防幽门螺杆菌感染提供依据。方法 选择2016年1月-2021年6月于无锡市第二中医医院行幽门螺杆菌检查的患者,收集性别、年龄基本资料和^(13)C-尿素呼气试验、幽门螺杆菌药敏培养结果。结果 幽门螺杆菌感染率为54.34%(3872/7131),<60岁患者随着年龄增大感染率逐渐上升。对430例幽门螺杆菌培养的药敏结果分析发现,对一种及以上抗生素耐药的菌株检出率达97.67%(420/430),对两种及以上抗生素耐药的菌株检出率为68.14%(293/430)。单药耐药情况,甲硝唑在各年度、各年龄段中的耐药率均极高,阿莫西林、四环素、呋喃唑酮的耐药率均较低。组合药物耐药情况,各年度、各年龄段均以四环素与呋喃唑酮的组合耐药率最低。其次为四环素、呋喃唑酮分别与阿莫西林组合。幽门螺杆菌的平均根除率为82.39%。结论 幽门螺杆菌的感染率较高。高耐药率、多重耐药菌增加了根除幽门螺杆菌的难度。各年龄段对甲硝唑的耐药率均极高,不宜选用。针对60岁以上的老年人根除幽门螺杆菌时克拉霉素、左氧氟沙星不宜选用。四环素、呋喃唑酮和阿莫西林三者两两组合耐药率低,对不同年龄段幽门螺杆菌感染者均是理想的抗菌药物组合。OBJECTIVE To explore the epidemiological characteristics of Helicobacter pylori infection so as to provide guidance for prevention of H.pylori infection.METHODS The patients who received H.pylori test in Wuxi Second Hospital of Traditional Chinese Medicine from Jan 2016 to Jun 2021 were enrolled in the study.The baseline data gender,age and the results of ^(13)C-urea breath test and drug susceptibility testing for H.pylori were collected.RESULTS The prevalence rate of H.pylori infection was 54.34%(3872/7131),the infection rate of the patients less than 60 years old was increased with the age.The result of drug susceptibility testing for 430 cases of H.pylori showed that the isolation rate of the strains that were resistant to no less than 1 type of antibiotic reached up to 97.67%(420/430),the isolation rate of the strains that were resistant to no less than 2 types of antibiotics was 68.14%(293/430).In terms of one-drug resistance,the drug resistance rate to metronidazole was extremely high in the different years and among the patients of different age groups,and the drug resistance rates to amoxicillin,tetracycline and furazolidone were relatively low.In terms of combined drugs resistance,the drug resistance rate to tetracycline combined with furazolidone was the lowest,followed by tetracycline combined with amoxicillin and furazolidone combined with amoxicillin.The average eradication rate of H.pylori was 82.39%.CONCLUSION The incidence of H.pylori infection is high.The high drug resistance rate and multidrug-resistant organisms increase the difficulty in eradicating H.pylori.Metronidazole is inappropriate to choose for all the age groups due to the high drug resistance rate.Clarithromycin and levofloxacin are not suitable for the elderly aged more than 60 years old to eradicate H.pylori.The drug resistance rate to each two combination of tetracycline,furazolidone and amoxicillin is low and is an ideal combination for the patients with H.pylori infection of different age groups.

关 键 词：幽门螺杆菌 流行病学 药敏试验 耐药性 筛查人群 无锡 

分 类 号：R378[医药卫生—病原生物学]