Prevalence of Primary Fluoroquinolone Resistance Among Clinical Isolates of Helicobacter pylori at a University Hospital in Southern Taiwan
Prevalence of Primary Fluoroquinolone Resistance Among Clinical Isolates of Helicobacter pylori at a University Hospital in Southern Taiwan
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DOI：
10.1111/j.1523-5378.2009.00655.x
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发表时间：
2009-02-01
期刊：
影响因子：
4.4
通讯作者：
Wu, Jiunn-Jong
中科院分区：
文献类型：
--
作者：
Hung, Kuei-Hsiang;Sheu, Bor-Shyang;Wu, Jiunn-Jong
氟喹诺酮类药物可有效根除幽门螺杆菌。然而，台湾地区幽门螺杆菌对氟喹诺酮类药物的耐药率尚未见报道。本研究从1998年4月至2007年9月收集台湾南部地区临床分离的210株幽门螺杆菌，以了解其对根除计划中常用抗生素及氟喹诺酮类药物的敏感性。用琼脂稀释法和Etest法测定了6种抗菌剂的体外活性。用直接测序法检测了gyrA和gyrB的喹诺酮类药物耐药决定区的突变情况，5.7%的菌株对环丙沙星和左氧氟沙星耐药。对阿莫西林、克拉霉素、甲硝唑和四环素的耐药率分别为1.0%(2/210)、9.5%(20/210)、27.6%(58/210)和0.5%(1/210)。对环丙沙星和左氧氟沙星的耐药率从1998-2003年的2.8%上升到2004-2007年的11.8%。GyrA基因N87或D91位突变影响幽门螺杆菌对氟喹诺酮类药物的耐药性。与目标最低抑菌浓度相比，加雷诺沙星对环丙沙星/左氧氟沙星耐药菌株有较好的体外抑制作用。2004-2007年收集的幽门螺杆菌对环丙沙星和左氧氟沙星的耐药性较1998-2003年的耐药水平显著增加。持续监测幽门螺杆菌对喹诺酮类药物的耐药性在这一领域具有重要意义。
Fluoroquinolone-containing therapy is effective in eradicating Helicobacter pylori. However, the resistance rate of H. pylori to fluoroquinolones in Taiwan has not yet been reported. In this study, we aimed to investigate the susceptibility to antibiotics commonly used in eradication schedules and fluoroquinolones in H. pylori.A total of 210 clinical isolates of H. pylori were collected from April 1998 to September 2007 from patients in southern Taiwan. The in vitro activities of six antimicrobial agents were determined by the agar dilution method and Etest. The mutations in quinolone resistance-determining regions of gyrA and gyrB were investigated by direct sequencing.Overall, 5.7% of the isolates were resistant to ciprofloxacin and levofloxacin. The resistance rate to amoxicillin, clarithromycin, metronidazole, and tetracycline was 1.0% (two of 210), 9.5% (20 of 210), 27.6% (58 of 210), and 0.5% (one of 210), respectively. The resistance rate to either ciprofloxacin or to levofloxacin increased from 2.8% (1998-2003) to 11.8% (2004-2007). The mutations in gyrA at N87 or D91 had an impact on primary fluoroquinolone resistance in H. pylori. Garenoxacin, but not moxifloxacin, had a good in vitro inhibitory effect against ciprofloxacin/levofloxacin-resistant strains compared with objective minimal inhibitory concentration values.Drug resistance to ciprofloxacin and levofloxacin in H. pylori collected from 2004 to 2007 increased significantly compared with resistance level observed during 1998-2003. The continuous surveillance of quinolone resistance among H. pylori is important in this area.