Changing antimicrobial susceptibility epidemiology of Helicobacter pylori strains in Japan between 2002 and 2005
Changing antimicrobial susceptibility epidemiology of Helicobacter pylori strains in Japan between 2002 and 2005
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DOI：
10.1128/jcm.00740-07
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发表时间：
2007-12-01
影响因子：
9.4
通讯作者：
Fujioka, Toshio
中科院分区：
文献类型：
--
作者：
Kobayashi, Intetsu;Murakami, Kazunari;Fujioka, Toshio
反映日本一般人群的幽门螺杆菌抗菌药物敏感性的监测是有限的。测定了3，707 H.对2002年10月至2005年9月期间在日本各地的36家医疗机构中从先前未经治疗的诊断为胃十二指肠疾病的患者的胃粘膜样品中分离的幽门螺杆菌菌株进行了评价。采用琼脂稀释法对H. pylori的MIC分布和趋势进行了研究。虽然克拉霉素的MIC（50）和MIC 90在3年期间没有变化，但MIC 80显示增加了128倍。此外，耐药率逐年上升，从18.9%（2002 - 2003年）上升到21.1%（2003 - 2004年）和27.7%（2004 - 2005年）。男性的耐药率为19.2%，女性为27.0%，性别差异有显著性（P < 0.0001）。我们的研究表明，在日本，克拉霉素耐药性增加的趋势正在演变，存在地理和性别差异以及临床疾病之间的差异。在此期间，未观察到阿莫西林和甲硝唑的耐药性发生显著变化。而H.幽门螺杆菌抗菌药物敏感性测试在日本一直存在争议，目前的经验方案不是基于代表一般人群的敏感性数据。开发了一种有效的H.在日本根除幽门螺杆菌的方案将需要持续的耐药性监测以及更好地了解耐药性的流行病学。
Surveillance of Helicobacter pylori antimicrobial susceptibility reflecting the general population in Japan is limited. The antimicrobial susceptibilities of 3,707 H. pylori strains isolated from gastric mucosa samples of previously untreated patients diagnosed with gastroduodenal diseases at 36 medical facilities located throughout Japan between October 2002 and September 2005 were evaluated. Using an agar dilution method for antimicrobial susceptibility testing of H. pylori, the MIC distributions and trends during the study period for clarithromycin, amoxicillin, and metronidazole were studied. While the MIC (50) and MIC90 for clarithromycin did not change during the 3-year period, the MIC80 showed a 128-fold increase. Furthermore, the rate of resistance increased yearly from 18.9% (2002 to 2003) to 21.1% (2003 to 2004) and 27.7% (2004 to 2005). With a resistance rate of 19.2% among males compared to 27.0% among females, a significant gender difference was observed (P < 0.0001). Our study shows that in Japan, there is an evolving trend towards increased resistance to clarithromycin with geographical and gender differences as well as between clinical disease conditions. No significant changes in resistance were observed for amoxicillin and metronidazole during the period. While the benefit of H. pylori antimicrobial susceptibility testing has been debated in Japan, current empirical regimens are not based on susceptibility data representative of the general population. The development of an effective H. pylori eradication regimen in Japan will require continued resistance surveillance as well as a better understanding of the epidemiology of resistance.