论文部分内容阅读
目的了解江苏省苏州市幽门螺杆菌(H.pylori)对抗生素的耐药情况,为提高幽门螺杆菌感染根除率提供依据。方法收集经胃镜活检快速尿素酶阳性的慢性胃炎及消化性溃疡患者506例,取胃窦黏膜组织,常规方法培养鉴定幽门螺杆菌,并对分离菌株进行药敏纸片法(KB)鉴定。结果结果506例慢性胃炎及消化性溃疡患者中,幽门螺杆菌分离率为76.1%;H.pylori对甲硝唑和克拉霉素的耐药率均较高,分别为75.5%及19.4%(P<0.001,P<0.05);对阿莫西林、呋喃唑酮、左氧氟沙星、头孢呋辛、莫西沙星仍保持较高的敏感性,耐药率依次分别为3.6%,2.2%,7.2%,0.0%,5.8%;H.pylori的快速尿素酶试验(RUT)阳性程度越强,培养阳性率就越高。结论苏州地区H.pylori根除治疗的抗生素应首选阿莫西林,呋喃唑酮、头孢呋辛、左氧氟沙星、莫西沙星等药物,避免使用甲硝唑,慎重选择克拉霉素。
Objective To understand the resistance of H.pylori to antibiotics in Suzhou City, Jiangsu Province, and to provide basis for improving the eradication rate of Helicobacter pylori infection. Methods A total of 506 patients with chronic gastritis and peptic ulcer were enrolled in this study. The antral mucosa tissues were collected and identified by routine method. The Helicobacter pylori strains were identified by susceptibility discography (KB). Results Among 506 patients with chronic gastritis and peptic ulcer, the rate of H. pylori isolation was 76.1%. The drug resistance rates of H.pylori to metronidazole and clarithromycin were higher, 75.5% and 19.4%, respectively (P <0.001, P <0.05). The resistance rates to amoxicillin, furazolidone, levofloxacin, cefuroxime and moxifloxacin were still high. The resistance rates were respectively 3.6%, 2.2%, 7.2%, 0.0% 5.8%. The stronger positive rate of H.pylori rapid urease test (RUT), the higher the positive rate of culture. Conclusion The antibiotics for the eradication of H.pylori in Suzhou should be the first choice of amoxicillin, furazolidone, cefuroxime, levofloxacin, moxifloxacin and other drugs to avoid the use of metronidazole, careful selection of clarithromycin.