Two-decade trends in primary Helicobacter pylori resistance to antibiotics in Bulgaria
Two-decade trends in primary Helicobacter pylori resistance to antibiotics in Bulgaria
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DOI：
10.1016/j.diagmicrobio.2010.03.010
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发表时间：
2010-08-01
影响因子：
2.9
通讯作者：
Mitov, Ivan
中科院分区：
文献类型：
--
作者：
Boyanova, Lyudmila;Nikolov, Rossen;Mitov, Ivan
评估抗生素耐药性的长期趋势可以更早预测耐药性模式的短期变化。本研究的目的是比较 2007 年至 2009 年 501 株幽门螺杆菌菌株与 1990 至 1995 年（179 株）的原发耐药率和抗生素 MIC，以检测 20 年耐药性演变。 2007年至2009年，儿童菌株对甲硝唑（16.4%）和环丙沙星（2.7%）的耐药率低于成人菌株（分别为27.3%和10.3%）。 2008年至2009年，与成人（17.4%）相比，更多儿童（29.3%）携带克拉霉素耐药菌株。 2007年至2009年克拉霉素总体耐药率(19.4%)远高于1990年至1995年(6.2%)。 1990-1995年红霉素MIC90比2007-2009年克拉霉素低142.2倍。2001-2004年克拉霉素MIC90增加>42倍。喹诺酮耐药率增加7.7倍，2007-2009年为9.2% 1990年至1995年期间增加了1.2%，MIC90增加了5倍。相反，阿莫西林耐药性从1996年至1999年的3.2%下降到2007年至2009年的0.4%。四环素的MIC90保持稳定，但甲硝唑和四环素的MIC50在1996年之前比2007年至2009年下降了约4倍。 总之，耐药性演变与耐药性之间的关联患者的年龄组以及全国门诊抗生素使用情况均已被发现。 ff。幽门螺杆菌对抗生素的耐药性表现出许多长期变化，克拉霉素的进化速度比其他抗生素更快。甲硝唑和四环素自1990年以来并未表现出耐药性演变，但表现出MIC50下降。只有将研究期限延长至20年，才发现环丙沙星耐药性显着增加。 (C) 2010 Elsevier Inc. 保留所有权利。
Evaluating long-term trends in antibiotic resistance can predict earlier the short-term changes in resistance patterns. The aim of the present study was to compare primary resistance rates in 501 Helicobacter pylori strains in 2007 to 2009 to those in 1990 to 1995 (179 strains) and the antibiotic MICs to detect the 20-year resistance evolution. In 2007 to 2009, strains from children exhibited lower resistance rates to metronidazole (16.4%) and ciprofloxacin (2.7%) than those from adults (27.3% and 10.3%, respectively). In 2008 to 2009, more children (29.3%) harbored clarithromycin-resistant strains compared to the adults (17.4%). Overall clarithromycin resistance rate (19.4%) in 2007 to 2009 was much higher than that in 1990 to 1995 (6.2%). MIC90 of erythromycin in 1990 to 1995 was 142.2-fold lower than that of clarithromycin in 2007 to 2009. Clarithromycin MIC90 increased >42-fold since 2001 to 2004. Quinolone resistance rate increased 7.7-fold, being 9.2% in 2007 to 2009 versus 1.2% in 1990 to 1995, with a 5-fold increase in MIC90. Conversely, the amoxicillin resistance decreased from 3.2% in 1996 to 1999 to 0.4% in 2007 to 2009. The MIC90's of tetracycline remained stable but MIC50's of both metronidazole and tetracycline before 1996 decreased about 4-fold to 2007 to 2009. In conclusion, associations between the resistance evolution and patients' age groups as well as the national outpatient antibiotic use have been found. ff. pylori resistance to antibiotics showed many long-term changes, with a more rapid evolution for clarithromycin than for the other antibiotics. Metronidazole and tetracycline did not show a resistance evolution but exhibited a decrease in MIC50 since 1990. The significant increase in ciprofloxacin resistance was found only by extending the study period to 20 years. (C) 2010 Elsevier Inc. All rights reserved.