Primary and combined resistance to four antimicrobial agents in Helicobacter pylori in Sofia, Bulgaria
Primary and combined resistance to four antimicrobial agents in Helicobacter pylori in Sofia, Bulgaria
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DOI：
10.1099/0022-1317-49-5-415
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发表时间：
2000-05-01
影响因子：
3
通讯作者：
Koumanova, R
中科院分区：
文献类型：
--
作者：
Boyanova, L;Stancheva, I;Koumanova, R
本研究的目的是通过琼脂筛选法（SAM）和改良纸片扩散法（MDDM）单独和联合使用，评估幽门螺杆菌对4种抗菌药物的原发性和联合耐药。对来自索菲亚三家医院的192例连续幽门螺杆菌阳性患者的治疗前幽门螺杆菌分离株进行了调查。用含有甲硝唑（5 μ g）、克拉霉素（15 μ g）或红霉素（15 μ g）、环丙沙星（5 μ g）和四环素（30 μ g）的纸片进行MDDM。以抑菌圈8 mg/L、克拉霉素> 2 mg/L、四环素>4 mg/L、环丙沙星>1 mg/L为耐药标准。pylori：甲硝唑28.6%，克拉霉素9.7%，甲硝唑+克拉霉素2.8%，环丙沙星3.9%，甲硝唑+环丙沙星2.3%，四环素1.9%，甲硝唑+四环素1.2%。（5/44株）、8.3%（3/36株）和4.9%（2/41株）。两株菌对大环内酯类、甲硝唑、环丙沙星或四环素均表现出三重耐药。1999年检测到3株四环素耐药菌株，但6年间对其他药物的耐药率相对稳定。与大多数其他国家的结果相比，幽门螺杆菌对甲硝唑的原发性耐药性为中度，对克拉霉素和环丙沙星的耐药性相当大。携带联合耐药或多重耐药菌株的惊人出现为在全球、国家和区域各级继续监测幽门螺杆菌提供了动力。
The aim of this study was to evaluate the primary and combined resistance of Helicobacter pylori against four antimicrobial agents by a screening agar method (SAM) and a modified disk diffusion method (MDDM) alone and in combination. Pre-treatment H, pylori isolates from 192 consecutive H, pylori-positive patients at three hospitals in Sofia were investigated. MDDM was performed with disks containing metronidazole (5 mu g), clarithromycin (15 mu g) or erythromycin (15 mu g), ciprofloxacin (5 mu g) and tetracycline (30 mu g). Resistance was determined by an inhibitory zone of 8mg/L, clarithromycin >2mg/L, tetracycline >4 mg/L and ciprofloxacin >1 mg/L, Primary resistance rates in H. pylori were: metronidazole 28,6%, clarithromycin 9,7%, metronidazole + clarithromycin 2,8%, ciprofloxacin 3,9%, metronidazole + ciprofloxacin 2,3%, tetracycline 1.9% and metronidazole + tetracycline 1,2%, Among metronidazole-resistant isolates, combined resistance to clarithromycin, ciprofloxacin and tetracycline was present in 11.4% (5 of 44 strains), 8.3% (3 of 36) and 4.9% (2 of 41), respectively. Two strains exhibited triple resistance to macrolides, metronidazole and either ciprofloxacin or tetracycline. Three tetracycline-resistant strains were detected in 1999; however, resistance rates to other agents mere relatively stable during the 6 years. Primary H, pylori resistance to metronidazole is moderate and resistance to clarithromycin and to ciprofloxacin is considerable in comparison with results in most other countries, The alarming appearance of strains harbouring combined resistance or multiresistance provides the motivation for continued surveillance of H, pylori at global, national and regional levels.