无锡地区儿童幽门螺杆菌感染状况及耐药性分析  

Analysis of Helicobacter pylori infection status and drug resistance in children in Wuxi area

作　　者：黄骏峰 王旭阳 林琼 Huang Junfeng;Wang Xuyang;Lin Qiong(Department of Gastroenterology,Wuxi Children's Hospital,Jiangnan University,Wuxi 214000,China;Department of Pediatric Gastroenterology,Wuxi People's Hospital,Nanjing Medical University,Wuxi 214000,China)

机构地区：[1]江南大学附属无锡市儿童医院消化科,214000 [2]南京医科大学附属无锡人民医院儿消化科,214000

出　　处：《中国小儿急救医学》2024年第12期920-923,共4页Chinese Pediatric Emergency Medicine

基　　金：无锡市科技局医疗卫生科技公关项目(Y20232008)。

摘　　要：目的分析江苏省无锡地区儿童幽门螺杆菌(Hp)感染及耐药情况, 指导合理用药。方法收集2020年1月至2024年2月, 因上消化道症状于无锡市儿童医院消化内科门诊就诊并行胃镜检查的患儿临床资料, 分析其Hp感染及耐药情况。结果有上消化道症状并行胃镜检查患儿共2 119例, 胃黏膜Hp分离培养阳性669例(31.6%), 男363例、女306例, 不同性别间Hp阳性率差异无统计学意义(P>0.05);年龄<8岁41例(6.1%)、8~12岁300例(44.8%)、13~18岁328例(49.0%), 其中13~18岁年龄段患儿Hp阳性率高于8~12岁和<8岁, 不同年龄段间比较差异有统计学意义(χ^(2)=236.174, P<0.001)。药敏试验结果显示, 669株Hp对甲硝唑、克拉霉素和左氧氟沙星的单一耐药率分别为72.2%(483/669)、33.5%(224/669)、16.3%(109/669);未发现对呋喃唑酮、阿莫西林和四环素耐药的菌株。双重耐药菌株314株(46.9%), 对甲硝唑+克拉霉素、甲硝唑+左氧氟沙星和克拉霉素+左氧氟沙星的耐药率分别为23.5%(157/669)、14.2%(95/669)、9.3%(62/669)。三重耐药菌株48株(7.2%), 均为甲硝唑+克拉霉素+左氧氟沙星耐药菌株。不同性别和年龄段Hp感染患儿对甲硝唑、克拉霉素、左氧氟沙星的耐药率差异均无统计学意义(P>0.05)。结论无锡地区儿童Hp感染以大龄儿童为主, Hp对甲硝唑和克拉霉素耐药率较高, 在行Hp根除治疗时不推荐经验性使用, 建议根据药敏试验结果进行个体化的根除治疗。Objectivee To analyze Helicobacter pylori(Hp)infection and drug resistance in outpatient children in Wuxi,Jiangsu Province,China,and guide the rational use of drugs.MethodTs he clinical data of children who were treated in the outpatient clinic of the Gastroenterology Department at Wuxi Children's Hospital for upper gastrointestinal symptoms and underwent gastroscopy from January 2020 to February 2024 were collected.The Hp infection and drug resistance status were analyzed.Results A total of 2119 children with upper gastrointestinal symptoms underwent gastroscopy,of which 669 children(31.6%)had positive gastric mucosal Hp isolation and culture,including 363 males and 306 females,and there was no significant difference in Hp positivity rate between different genders(P>0.05).There were 41(6.1%)cases aged<8 years,300(44.8%)casesa ged 8~12 years,and 328(49.0%)cases aged 13~18 years,respectively,and the positive rate of Hp in the age group of 13~18 years was higher than those in 8~12 years and<8 years old,respectively,and the difference was statistically significant(χ^(2)=236.174,P<0.001).The results of the antimicrobial susceptibility test showed that the resistance rates of 669 strains of Hp to metronidazole,clarithromycin,and levofloxacin were 72.2%(483/669),33.5%(224/669),and 16.3%(109/669),respectively.No strains resistant to furazolidone,amoxicillin,or tetracycline were found.There were 314(46.9%)strains with dual drug resistance,and the drug resistance rates to metronidazole+clarithromycin,metronidazole+levofloxacin,and clarithromycin+levofloxacin were 23.5%(157/669),14.2%(95/669),and 9.3%(62/669),respectively.There were 48(7.2%)triple drug-resistant strains,all of which were resistant to metronidazole+clarithromycin+levofloxacin.There were no significant differences in the resistance rates of Hp to metronidazole,clarithromycin,and levofloxacin across different genders and among age groups(P>0.05).Conclusion Children with Hp infection in Wuxi area are mainly older children.The resistance rates of Hp to metroni

关 键 词：幽门螺杆菌 抗生素 耐药性 儿童 

分 类 号：R44[医药卫生—诊断学]