摘要
目的 抗生素耐药越来越被公认为是根除幽门螺杆菌 (Hp)治疗失败的主要原因。比较根除Hp常用抗生素耐药性发生倾向和监测耐药率。 方法 选用 7株敏感菌株 (其中 2株为标准菌株 )进行阿莫西林、四环素、呋喃唑酮、甲硝唑和克拉霉素 5种抗生素的体外诱导耐药试验。随机选取 2 0 0 0～ 2 0 0 1年间保存的 16 5株菌株 ,用琼脂稀释法测定最低抑菌浓度 (MIC) ,对上述 5种抗生素进行耐药监测。结果 体外诱导试验显示 ,7株Hp中 5株诱导出甲硝唑耐药 ,且可诱导倍数最高。 5株诱导出四环素耐药。虽未诱导出克拉霉素耐药 ,但有 1株可诱导倍数较高。未诱导出阿莫西林或呋喃唑酮耐药 ,呋喃唑酮可诱导倍数最低。耐药监测甲硝唑耐药率为 4 9.7% (82 / 16 5 ) ,克拉霉素为 7.3% (12 / 16 5 ) ,阿莫西林为 1.2 % (2 / 16 5 ) ,四环素为 2 .4 % (4/ 16 5 ) ,呋喃唑酮为 1.2 % (2 / 16 5 )。结论 Hp对甲硝唑很容易产生耐药 ,对克拉霉素可产生耐药 ,对呋喃唑酮和阿莫西林不易产生耐药。除四环素外 ,Hp对其他 4种抗生素发生耐药的难易程度与实际监测的耐药率高低相关 。
Objective Antibiotic resistance has increasingly been recognized as the major cause of treatment failure for Helicobacter pylori infection. The study was designed to compare the propensity of Helicobacter pylori to develop in vitro resistance to five commonly used antibiotics and to investigate the rates of resistance to these five antibiotics. Methods The serial passage tests were done in 7 sensitive Helicobacter pylori strains (2 type strains and 5 clinical isolates) to induce the resistance to amoxycillin, tetracycline, furazolidone, metronidazole or clarithromycin in vitro. The agar dilution tests detecting the minimal inhibitory concentration (MIC) were performed in 165 strains of Helicobacter pylori isolated from 2000 to 2001 to determine the resistance rates to the 5 antibiotics mentioned above. Results Serial passage tests showed that 5 of 7 strains of Helicobacter pylori were induced to be resistant to metronidazole and tetracycline; the inducible multiple of metronidazole was the highest. No strain was induced to be resistant to clarithromycin, but the inducible multiple of one strain was relatively high. No strain was induced to be resistant to amoxycillin or furazolidone, and the inducible multiple of furazolidone was the lowest. The resistance rates of Helicobacter pylori to metronidazole, clarithromycin, amoxycillin, tetracycline and furazolidone were 49.7% (82/165), 7.3%(12/165), 1.2% (2/165), 2.4%(4/165) and 1.2%(2/165), respectively. Conclusions Our study indicate that it is quite easy to induce the resistance to metronidazole,not difficult to clarithromycin, and relatively difficult to furazolidone or amoxycillin. The relative degree of difficulty in inducing the resistance to the drugs other than tetracycline is associated with the resistance rates detected, the fact that may help predict the changing trend of resistance rates in general population.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2003年第3期146-149,共4页
Chinese Journal of Digestion
