Increase in antibiotic resistant Helicobacter pylori in a University Hospital in Japan
Increase in antibiotic resistant Helicobacter pylori in a University Hospital in Japan
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DOI：
10.2147/idr.s196452
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发表时间：
2019-01-01
影响因子：
3.9
通讯作者：
Okada, Hiroyuki
中科院分区：
文献类型：
--
作者：
Kageyama, Chihiro;Sato, Mayu;Okada, Hiroyuki
背景：根除幽门螺杆菌可有效预防幽门螺杆菌相关疾病;幽门螺杆菌抗生素耐药性在整个日本和世界范围内增加。本研究的目的是评估日本一所大学医院的抗生素耐药率;阿莫西林，克拉霉素和甲硝唑。pylori（208株）从日本冈山大学医院的患者中分离。使用E-检验的平均值确定最小抑菌浓度（MIC），以确定菌株的抗微生物药敏性。结果：阿莫西林、克拉霉素和甲硝唑的耐药率分别为13%、48%和49%。遗传学分析表明23 SrDNA A2143 G点突变与克拉霉素的MIC密切相关。阿莫西林耐药菌株的MIC随着PBP 1A氨基酸突变数量的增加而增加。结论：阿莫西林耐药菌株的遗传分析在临床上是无效的。在大学医院等大型医院中已经分离出许多具有高抗生素耐药性的细菌。对于有效的根除治疗，应考虑通过几种方法测量MIC。
Background: Eradication effectively prevents Helicobacter pylori-associated diseases; however, H. pylori antibiotic resistance has increased throughout Japan and worldwide. This study aimed to assess rates of resistance to antibiotics; amoxicillin, clarithromycin and metronidazole in a University Hospital in Japan.Materials and methods: H. pylori (208 strains) were isolated from patients at the Okayama University Hospital in Japan. The minimum inhibitory concentrations (MIC) were determined using the mean values of the E-test to determine the antimicrobial susceptibilities of the strains. Sequencing and gene analysis were performed to analyze resistance genes to clarithromycin and amoxicillin.Results: Rates of amoxicillin, clarithromycin, and metronidazole resistance were 13%, 48%, and 49%, respectively. Genetic analysis indicated that the A2143G point mutation in 23S rDNA is closely associated with the MIC of clarithromycin. The MIC in amoxicillin-resistant strains increased with an increase in the number of PBP1A amino acids mutations.Conclusion: Genetic analysis for resistant strains is not clinically effective in cases of amoxicillin resistance. Numerous bacteria with already high antibiotic resistance rates have been isolated in large hospitals such as a University Hospital. For effective eradication therapy, MIC measurement should be considered via several methods.