AIM:To determine the resistance patterns of Helicobacter pylori(H.pylori) strains isolated from patients in Beijing and monitor the change of antibiotic resistance over time.METHODS:In this prospective,serial and cros...AIM:To determine the resistance patterns of Helicobacter pylori(H.pylori) strains isolated from patients in Beijing and monitor the change of antibiotic resistance over time.METHODS:In this prospective,serial and crosssectional study,H.pylori cultures were successfully obtained from 371 and 950 patients(never receiving eradication) during 2009-2010 and 2013-2014,respectively.Resistance to amoxicillin,clarithromycin,metronidazole,levofloxacin,tetracycline,and rifampicin was determined by Epsilometer test.RESULTS:The resistance rates of isolates obtained during 2009-2010 were 66.8%,39.9%,34.5%,15.4%,6.7%,and 4.9% to metronidazole,clarithromycin,levofloxacin,rifampicin,amoxicillin and tetracycline,respectively; and the corresponding rates for isolates during 2013-2014 were 63.4%,52.6%,54.8%,18.2%,4.4% and 7.3%,respectively.The resistance rates to clarithromycin and levofloxacin were significantly increased after four years.In 2009-2010,14.6% of H.pylori isolates were susceptible to all tested antibiotics,with mono(33.7%),double(28.3%),triple(16.7%),quadruple(6.2%),quintuple(0.3%) and sextuple resistance(0.3%) also being detected.In 2013-2014,9.4% were susceptible to all tested antibiotics,and mono(27.6%),double(28.4%),triple(24.9%),quadruple(7.3%),quintuple(2.3%) and sextuple resistance(0.1%) was also observed.More multiple resistant H.pylori isolates were found during 2013-2014.Gender(to levofloxacin and metronidazole),age(to levofloxacin) and endoscopic findings(to clarithromycin) were independent factors influencing antibiotic resistance.CONCLUSION:H.pylori resistance to commonly used antibiotics in Beijing is high with increased multiple antibiotic resistance.展开更多
IS THERE ANYTHING NEW?Helicobacter pylori has been for many years aforgotten bacterium,since the first report on thisspiral organism dated from the 19th century.Asearly as in 1906,an association between a spiralorgani...IS THERE ANYTHING NEW?Helicobacter pylori has been for many years aforgotten bacterium,since the first report on thisspiral organism dated from the 19th century.Asearly as in 1906,an association between a spiralorganism and gastric carcinoma was suggested.Doenges reported in 1938 that on autopsy not展开更多
Helicobacter pylori(H. pylori) infection is very common and affects approximately half of the world population. It causes gastric diseases, but some authors have reported an association of H. pylori infection with oth...Helicobacter pylori(H. pylori) infection is very common and affects approximately half of the world population. It causes gastric diseases, but some authors have reported an association of H. pylori infection with other systemic manifestations beginning in 1994. The list of potential effects of H. pylori outside the stomach includes a number of extragastric manifestations and we focused on neurological, dermatological, hematologic, ocular, cardiovascular, metabolic, allergic, and hepatobiliary diseases. This review discusses these important reported manifestations that are not related to the gastrointestinal tract.展开更多
Helicobacter pylori(H.pylori)is a gram-negative bacterium that infects approximately 4.4 billion individuals worldwide.However,its prevalence varies among different geographic areas,and is influenced by several factor...Helicobacter pylori(H.pylori)is a gram-negative bacterium that infects approximately 4.4 billion individuals worldwide.However,its prevalence varies among different geographic areas,and is influenced by several factors.The infection can be acquired by means of oral-oral or fecal-oral transmission,and the pathogen possesses various mechanisms that improve its capacity of mobility,adherence and manipulation of the gastric microenvironment,making possible the colonization of an organ with a highly acidic lumen.In addition,H.pylori presents a large variety of virulence factors that improve its pathogenicity,of which we highlight cytotoxin associated antigen A,vacuolating cytotoxin,duodenal ulcer promoting gene A protein,outer inflammatory protein and gamma-glutamyl transpeptidase.The host immune system,mainly by means of a Th1-polarized response,also plays a crucial role in the infection course.Although most H.pylori-positive individuals remain asymptomatic,the infection predisposes the development of various clinical conditions as peptic ulcers,gastric adenocarcinomas and mucosa-associated lymphoid tissue lymphomas.Invasive and non-invasive diagnostic methods,each of them with their related advantages and limitations,have been applied in H.pylori detection.Moreover,bacterial resistance to antimicrobial therapy is a major challenge in the treatment of this infection,and new therapy alternatives are being tested to improve H.pylori eradication.Last but not least,the development of effective vaccines against H.pylori infection have been the aim of several research studies.展开更多
目的了解幽门螺杆菌(Hp)耐药菌株以及患者性别、年龄和不同临床疾病对 Hp 根除治疗的影响,阐明 Hp 根除治疗失败的主要原因。方法对因上胃肠道症状而来北京大学第一医院胃镜室接受胃镜检查的 Hp 培养阳性患者,采用 E-试验法测定 Hp 菌...目的了解幽门螺杆菌(Hp)耐药菌株以及患者性别、年龄和不同临床疾病对 Hp 根除治疗的影响,阐明 Hp 根除治疗失败的主要原因。方法对因上胃肠道症状而来北京大学第一医院胃镜室接受胃镜检查的 Hp 培养阳性患者,采用 E-试验法测定 Hp 菌株对甲硝唑及克拉霉素的最低抑菌浓度(MIC)。对所有入选患者采用兰索拉唑、甲硝唑和克拉霉素的三联7d 疗法进行 Hp 根除治疗。结果共有157例患者进入本研究,并完成了治疗。Hp 对甲硝唑和克拉霉素的耐药率分别为:45.9％(72/157)和18.5％(29/157)。157例接受治疗患者的 Hp 根除率为61.8％(97/157),Hp 根除率在不同性别、年龄及不同临床疾病患者之间差异均无统计学意义(均 P>0.05);甲硝唑敏感菌株和耐药菌株的根除率分别为89.4％(76/85)和29.2％(21/72)(P<0.01)。克拉霉素敏感菌株和耐药菌株的根除率分别为72.7％(93/128)和16.0％(4/29)(P<0.01)。结论 Hp 对抗生素耐药是导致Hp 根除治疗失败的主要原因。展开更多
基金Supported by National Science and Technology Pillar Program during the Twelfth Five-year Plan Period,No.2012BAI06B02the Capital Health Research and Development of Special,No.2011-4032-02
文摘AIM:To determine the resistance patterns of Helicobacter pylori(H.pylori) strains isolated from patients in Beijing and monitor the change of antibiotic resistance over time.METHODS:In this prospective,serial and crosssectional study,H.pylori cultures were successfully obtained from 371 and 950 patients(never receiving eradication) during 2009-2010 and 2013-2014,respectively.Resistance to amoxicillin,clarithromycin,metronidazole,levofloxacin,tetracycline,and rifampicin was determined by Epsilometer test.RESULTS:The resistance rates of isolates obtained during 2009-2010 were 66.8%,39.9%,34.5%,15.4%,6.7%,and 4.9% to metronidazole,clarithromycin,levofloxacin,rifampicin,amoxicillin and tetracycline,respectively; and the corresponding rates for isolates during 2013-2014 were 63.4%,52.6%,54.8%,18.2%,4.4% and 7.3%,respectively.The resistance rates to clarithromycin and levofloxacin were significantly increased after four years.In 2009-2010,14.6% of H.pylori isolates were susceptible to all tested antibiotics,with mono(33.7%),double(28.3%),triple(16.7%),quadruple(6.2%),quintuple(0.3%) and sextuple resistance(0.3%) also being detected.In 2013-2014,9.4% were susceptible to all tested antibiotics,and mono(27.6%),double(28.4%),triple(24.9%),quadruple(7.3%),quintuple(2.3%) and sextuple resistance(0.1%) was also observed.More multiple resistant H.pylori isolates were found during 2013-2014.Gender(to levofloxacin and metronidazole),age(to levofloxacin) and endoscopic findings(to clarithromycin) were independent factors influencing antibiotic resistance.CONCLUSION:H.pylori resistance to commonly used antibiotics in Beijing is high with increased multiple antibiotic resistance.
文摘IS THERE ANYTHING NEW?Helicobacter pylori has been for many years aforgotten bacterium,since the first report on thisspiral organism dated from the 19th century.Asearly as in 1906,an association between a spiralorganism and gastric carcinoma was suggested.Doenges reported in 1938 that on autopsy not
文摘Helicobacter pylori(H. pylori) infection is very common and affects approximately half of the world population. It causes gastric diseases, but some authors have reported an association of H. pylori infection with other systemic manifestations beginning in 1994. The list of potential effects of H. pylori outside the stomach includes a number of extragastric manifestations and we focused on neurological, dermatological, hematologic, ocular, cardiovascular, metabolic, allergic, and hepatobiliary diseases. This review discusses these important reported manifestations that are not related to the gastrointestinal tract.
文摘Helicobacter pylori(H.pylori)is a gram-negative bacterium that infects approximately 4.4 billion individuals worldwide.However,its prevalence varies among different geographic areas,and is influenced by several factors.The infection can be acquired by means of oral-oral or fecal-oral transmission,and the pathogen possesses various mechanisms that improve its capacity of mobility,adherence and manipulation of the gastric microenvironment,making possible the colonization of an organ with a highly acidic lumen.In addition,H.pylori presents a large variety of virulence factors that improve its pathogenicity,of which we highlight cytotoxin associated antigen A,vacuolating cytotoxin,duodenal ulcer promoting gene A protein,outer inflammatory protein and gamma-glutamyl transpeptidase.The host immune system,mainly by means of a Th1-polarized response,also plays a crucial role in the infection course.Although most H.pylori-positive individuals remain asymptomatic,the infection predisposes the development of various clinical conditions as peptic ulcers,gastric adenocarcinomas and mucosa-associated lymphoid tissue lymphomas.Invasive and non-invasive diagnostic methods,each of them with their related advantages and limitations,have been applied in H.pylori detection.Moreover,bacterial resistance to antimicrobial therapy is a major challenge in the treatment of this infection,and new therapy alternatives are being tested to improve H.pylori eradication.Last but not least,the development of effective vaccines against H.pylori infection have been the aim of several research studies.
文摘目的了解幽门螺杆菌(Hp)耐药菌株以及患者性别、年龄和不同临床疾病对 Hp 根除治疗的影响,阐明 Hp 根除治疗失败的主要原因。方法对因上胃肠道症状而来北京大学第一医院胃镜室接受胃镜检查的 Hp 培养阳性患者,采用 E-试验法测定 Hp 菌株对甲硝唑及克拉霉素的最低抑菌浓度(MIC)。对所有入选患者采用兰索拉唑、甲硝唑和克拉霉素的三联7d 疗法进行 Hp 根除治疗。结果共有157例患者进入本研究,并完成了治疗。Hp 对甲硝唑和克拉霉素的耐药率分别为:45.9％(72/157)和18.5％(29/157)。157例接受治疗患者的 Hp 根除率为61.8％(97/157),Hp 根除率在不同性别、年龄及不同临床疾病患者之间差异均无统计学意义(均 P>0.05);甲硝唑敏感菌株和耐药菌株的根除率分别为89.4％(76/85)和29.2％(21/72)(P<0.01)。克拉霉素敏感菌株和耐药菌株的根除率分别为72.7％(93/128)和16.0％(4/29)(P<0.01)。结论 Hp 对抗生素耐药是导致Hp 根除治疗失败的主要原因。
