Hp抗菌藥耐藥性的研究：在我國北京和東南沿海地區(qū)

1、目錄目錄The study of antibiotic resistance to H.pylori isolated from Beijing and Southeast Coastal Region of China目錄目錄簡介簡介nThe antimicrobials resistance of Helicobacter pylori (H. pylori) was able to sharply decline the eradication rate of H. pylori both in adults and children, but there are limited stu

2、dies about the primary antibiotic resistance and the related gene mutations, specifically in China.nChinese Center for Disease Control and Prevention studied antibiotic resistance of H.pylori isolated from Beijing children and in the Southeast Coastal Region of China, respectively. 目錄目錄Study OnePrim

3、aryantibioticresistanceofHelicobacterpyloriisolatedfromBeijingchildren目錄目錄BACKGROUNDBACKGROUNDnThe antimicrobials resistance of H. pylori was able to sharply decline the eradication rate of H. pylori both in adults and children, but there are limited studies about the primary antibiotic resistance a

4、nd the related gene mutations, specifically in China.目錄目錄MATERIALS AND METHODS MATERIALS AND METHODS nThe primary resistance to 9 antibiotics of 73 H. pylori strains isolated from gastric biopsies of children recruited at Beijing Childrens Hospital was assessed, and the mutations in 23S rRNA gene of

5、 65 macrolide-resistant strains and in gyrA and gyrB of 12 quinolone-resistant strains were investigated.目錄目錄RESEULTSRESEULTS1.The resistance rate to clarithromycin, azithromycin, metronidazole, levofloxacin, moxifloxacin, and rifampicin was 84.9%, 87.7%, 61.6%, 13.7%, 15.1%, and 6.8%, respectively.

6、 No resistance to amoxicillin, gentamicin, and tetracycline was observed. 2.Dual, triple, and quadruple antibacterial resistant percentage was 46.6% (34/73), 15.1% (11/73), and 2.7% (2/73), respectively. 目錄目錄RESULTSRESULTS3.The gene mutation rate of A2142C, A2142G, and A2143G in 23S rRNA gene was 1.

7、5% (1/65), 6.2% (4/65), and 84.6% (55/65), respectively. 4.The detection rate of mutations of Asn87, Asp91, and Met191 in GyrA was 41.7% (5/12), 25% (3/12), and 25% (3/12), respectively.目錄目錄CONCLUSIONSCONCLUSIONSnThe high prevalence of primary antibiotic resistance was out of expectation in H. pylor

8、i strains isolated from the children in Beijing.nAntibiotic susceptibility should be made clear before the antibiotic was used in the anti-H. pylori therapy in this population. nThe A2143G was the most populated mutation in macrolide-resistant strains, and Asn87 and Asp91 of GyrA were the most commo

9、n mutation points in quinolone resistance strains.目錄目錄LiuG,XuX,HeL,DingZ,GuY,ZhangJ,ZhouL.PrimaryantibioticresistanceofHelicobacterpyloriisolatedfromBeijingchildren.Helicobacter2011;16:356-362.目錄目錄Study TwoAntibioticresistanceofHelicobacterpyloriisolatedintheSoutheastCoastalRegionofChina目錄目錄BACKGROU

10、NDBACKGROUNDnThe resistance of Helicobacter pylori (H. pylori) to antibiotics is increasing worldwide, lowering its efficacy in current eradication therapies. This study evaluated H. pylori resistance to antibiotics in the southeast coastal region of China and suggests appropriate alternatives.目錄目錄M

11、ATERIALS AND METHODS MATERIALS AND METHODS nSeventeen thousand seven hundred and thirty one H. pylori strains were collected from eight areas of two provinces in coastal southeast China from 2010 to 2012. nThe resistance of these strains to six antibiotics was tested using the agar dilution method.目

12、錄目錄Figure1Helicobacterpylorisamplequantitiesindifferentareas.ThegeographiccoverageofZhejiangandJiangsuprovincearefilledwithdifferentcolorsinthemapofcoastalsoutheastChina.Theredpointsrepresentrelativelocationsofeverysamplingarea.Citynamesandsamplequantitiesarelabelednexttothecorrespondingredpoints.目錄

13、目錄RESEULTSRESEULTS1.The resistance rates to clarithromycin, metronidazole, levofloxacin, amoxicillin, gentamicin and furazolidone were 21.5, 95.4, 20.6, 0.1, 0.1 and 0.1%, respectively. 2.Double, triple and quadruple antibacterial resistant percentages were 25.5, 7.5 and 0.1%, respectively. 目錄目錄RESU

14、LTSRESULTS3.A positive association between the resistance to levofloxacin and to clarithromycin was found, but there was a negative correlation in the resistances to levofloxacin and to metronidazole.目錄目錄Figure2Distributionofresistancepatternsamong17,210antibioticresistantH.pyloristrains.Thenumberso

15、ntopofthebarsrepresentthequantityofstrainsintotal,single,double,triple,orquadrupleresistance.Thepercentageswithinthebarsrepresenttheproportionsofmainandotherpatternsintotal,single,double,triple,andquadrupleresistance.MTZ,metronidazole;LVX,levofloxacin;CLR,clarithromycin.目錄目錄CONCLUSIONSCONCLUSIONSnThe prevalence of H. pylori resistance to clarithromycin, metronidazole, levofloxacin and multiple antibiotics in coastal southeast China is high. nChoice of therapy shou