Antimicrobial resistance of Helicobacter pylori strains to five antibiotics, including levofloxacin, in Northwestern Turkey
Antimicrobial resistance of Helicobacter pylori strains to five antibiotics, including levofloxacin, in Northwestern Turkey
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DOI：
10.1590/0037-8682-0027-2015
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发表时间：
2015-06-01
影响因子：
2
通讯作者：
Kocazeybek, Bekir
中科院分区：
文献类型：
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作者：
Caliskan, Reyhan;Tokman, Hrisi Bahar;Kocazeybek, Bekir
前言：抗生素耐药性是影响目前幽门螺杆菌治疗方案疗效的主要因素。本研究目的是了解耐药菌株对克拉霉素、阿莫西林、四环素、左氧氟沙星和甲硝唑的耐药率。从土耳其消化不良患者中分离的幽门螺杆菌菌株。方法：H.幽门螺杆菌培养从胃体和胃窦活检，收集消化不良症状的患者，和抗菌药物敏感性的H。根据EUCAST折点，使用E-test（克拉霉素、阿莫西林、四环素、甲硝唑和左氧氟沙星）测定幽门螺杆菌。采用实时荧光定量PCR检测克拉霉素耐药菌株23 S rRNA基因点突变。结果：共获得98株H.幽门螺杆菌菌株分离，所有这些都是敏感的阿莫西林和四环素。对克拉霉素耐药率为36.7%（36/98），对甲硝唑耐药率为35.5%（34/98），对左氧氟沙星耐药率为29.5%（29/98）。多重耐药率为19.3%。克拉霉素耐药菌株36株（100%）均存在23 SrRNA编码基因A2143 G和A2144 G点突变。此外，左氧氟沙星的MIC值增加到32 mg/L，在我们的H。pylori菌株。克拉霉素耐药菌株中，左氧氟沙星耐药率为27.2%，甲硝唑耐药率为45.4%。结论：我们的结论是，克拉霉素或左氧氟沙星为基础的三联疗法治疗失败并不奇怪，甲硝唑不是一个可靠的药物根除H。土耳其的幽门螺杆菌感染。
Introduction: Antibiotic resistance is the main factor that affects the efficacy of current therapeutic regimens against Helicobacter pylori. This study aimed to determine the rates of resistance to efficacy clarithromycin, amoxicillin, tetracycline, levofloxacin and metronidazole among H. pylori strains isolated from Turkish patients with dyspepsia. Methods: H. pylori was cultured from corpus and antrum biopsies that were collected from patients with dyspeptic symptoms, and the antimicrobial susceptibility of H. pylori was determined using the E-test (clarithromycin, amoxicillin, tetracycline, metronidazole and levofloxacin) according to the EUCAST breakpoints. Point mutations in the 23S rRNA gene of clarithromycin-resistant strains were investigated using real-time PCR. Results: A total of 98 H. pylori strains were isolated, all of which were susceptible to amoxicillin and tetracycline. Of these strains, 36.7% (36/98) were resistant to clarithromycin, 35.5% (34/98) were resistant to metronidazole, and 29.5% (29/98) were resistant to levofloxacin. Multiple resistance was detected in 19.3% of the isolates. The A2143G and A2144G point mutations in the 23S rRNA-encoding gene were found in all 36 (100%) of the clarithromycin-resistant strains. Additionally, the levofloxacin MIC values increased to 32 mg/L in our H. pylori strains. Finally, among the clarithromycin-resistant strains, 27.2% were resistant to levofloxacin, and 45.4% were resistant to metronidazole. Conclusions: We conclude that treatment failure after clarithromycin-or levofloxacin-based triple therapy is not surprising and that metronidazole is not a reliable agent for the eradication of H. pylori infection in Turkey.