Antibiotic Resistance of Helicobacter pylori in Mazandaran, North of Iran
Antibiotic Resistance of Helicobacter pylori in Mazandaran, North of Iran
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DOI：
10.1111/j.1523-5378.2010.00795.x
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发表时间：
2010-12-01
期刊：
影响因子：
4.4
通讯作者：
Wolfram, Lutz
中科院分区：
文献类型：
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作者：
Abadi, Amin Talebi Bezmin;Mobarez, Ashraf M.;Wolfram, Lutz
背景：本研究的目的是调查伊朗患者幽门螺杆菌对甲硝唑、克拉霉素、阿莫西林和四环素等常用抗生素的耐药率。幽门螺杆菌分离株是从 2007 年至 2010 年转诊至伊朗萨里图巴医疗中心接受上消化道内窥镜检查的患者的胃活检中收集的。他们中没有人至少 8 个月使用过抗生素。根据形态学形状和过氧化氢酶、氧化酶和脲酶活性的阳性生化测试来鉴定幽门螺杆菌。采用epsilometer试验研究了甲硝唑、克拉霉素、阿莫西林和四环素的抗生素耐药性。耐药性的定义是阿莫西林 (AMX) 的最低抑菌浓度 (MIC) > 0.5 mg/L，四环素 (TET) > 4 mg/L，甲硝唑 (MTZ) > 8 mg/L，克拉霉素 (CLR) > 1 mg/L。 结果：从 132 名患者中收集菌株，平均年龄 45.8 岁，其中 52 名 (39%) 为女性。患者的诊断多种多样：胃炎 42 例（31.8%）、十二指肠溃疡 45 例（34%）、胃癌 15 例（11.3%）或胃溃疡 30 例（22.7%）。患者分离出的幽门螺杆菌耐药率分别为甲硝唑73.4%、克拉霉素30%、阿莫西林6.8%、四环素9%。 28 例 (21.2%) 对 MTZ-CLR 具有双重耐药性，16 例 (12.1%) 对 MTZ-CLR-AMX 显示三重耐药性，8 例 (6%) 对所有四种测试抗生素 (MTZ-CLR-AMX-TET) 均具有耐药性。未检测到多种耐药菌株与临床表现之间存在关联 (p > .05)。结论：伊朗幽门螺杆菌对甲硝唑和克拉霉素抗生素耐药性的流行率较高，这与该国报道的幽门螺杆菌治疗成功率较低的情况一致。
Background:The aim of this study was to investigate the prevalence of resistances in Helicobacter pylori against commonly used antibiotics including metronidazole, clarithromycin, amoxicillin, and tetracycline in Iranian patients.Methods:H. pylori isolates were collected from gastric biopsies from patients referred for upper gastrointestinal endoscopy at Tooba Medical Center, Sari, Iran, from 2007 to 2010. None of them had been using antibiotics for at least 8 months. H. pylori was identified based on morphological shape and positive biochemical tests for catalase, oxidase, and urease activity. Antibiotic resistance for metronidazole, clarithromycin, amoxicillin, and tetracycline was investigated by using epsilometer test. Resistance was defined by minimal inhibitory concentration (MIC) > 0.5 mg/L for amoxicillin (AMX), > 4 mg/L for tetracycline (TET), > 8 mg/L for metronidazole (MTZ), and > 1 mg/L for clarithromycin (CLR).Results:Strains were collected from 132 patients, mean age 45.8 years, 52 (39%) were women. Patients had diverse diagnoses: gastritis 42 (31.8%), duodenal ulcer 45 (34%), gastric cancer 15 (11.3%), or gastric ulcer 30 (22.7%). The prevalences of resistance of H. pylori strains isolated from the patients were 73.4% for metronidazole, 30% for clarithromycin, 6.8% for amoxicillin, and 9% for tetracycline. Twenty-eight (21.2%) were double resistant to MTZ-CLR, 16 (12.1%) showed triple resistance to MTZ-CLR-AMX, and 8 (6%) were resistant to all four tested antibiotics (MTZ-CLR-AMX-TET). No associations were detected between multiple resistant strains and clinical manifestations (p > .05).Conclusions:The prevalence of H. pylori antibiotic resistance to metronidazole and clarithromycin was high in Iran consistent with the reported low success rates for H. pylori treatment in this country.