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Formulating a method of determining the efficacy of H.pylori eradication with pulsed field gel electrophoresis

制定脉冲场凝胶电泳测定幽门螺杆菌根除效果的方法

基本信息

批准号：
15590497
负责人：
CHEN Gelin
金额：
$ 1.79万
依托单位：
Showa University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2005
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-15590497/
关键词：
Helicobacter pylori pulsed-field gel electrophoresis genotyping eradication treatment drug resistance PCR cagA cancer 感染率家族内感染 HpSA ELISA パルスフィールドゲル電気泳動法

项目摘要

With a molecular technique, we attempted to determine the efficacy of Helicobacter pylori eradication, study changes in the rate of infection, and study the prevalence of cagA, a virulence factor for H.pylori.In the first year of the study, we compared H.pylori's pattern of sensitivity to the three agents of AMPC, CAM, and MNZ detected before and after eradication in a total of 28 specimens from before and 2-3 months after treatment in 14 cases in which eradication was performed with the three agents of LPZ+AMPC+CAM from January 2001-January 2002. We also studied the causes of eradication failure through genomic analysis with pulsed field gel electrophoresis (PFGE). In 5 cases where eradication failed, the genotypes before and after treatment matched. Three cases were sensitive to all 3 agents before and after eradication ; the remaining 2 cases had primary resistance to CAM before treatment. These cases cannot be considered to have acquired resistance due to eradication, so the cause … More of failed eradication was not development of resistance or re-infection but was because the eradication agents were not taken correctly.In the second year of the study, we examined changes in the rate of H.pylori infection using an HpSA ELISA reagent for fecal antigen detection and the state of infection of clinical technicians routinely handling H.pylori. With regard to the rate of infection, there was only a shift in positive rates for individual age groups in comparison to 10 years prior. Of 7 technicians routinely handling H.pylori, 2 were positive for H.pylori fecal antigens. In contrast to a report of a rate of H.pylori infection of 50% or more in health care personnel such as endoscopists, this phenomenon was not noted in bacteriology technicians involved in H.pylori testing.In the third year, we examined cagA, a virulence factor for H.pylori, with PCR. One hundred and six of 108 clinically isolates possessed cagA ; this agreed with a report of 95-100% of clinically isolates possessing cagA. This suggests that possession of cagA may not serve as an indicator for onset by H.pylori or prognosis. Less

通过分子技术，我们试图确定幽门螺杆菌的根除效果，研究感染率的变化，并研究幽门螺杆菌的毒力因子cagA的患病率。在研究的第一年，我们比较了幽门螺杆菌对AMPC， CAM，2001年1月至2002年1月，在14例使用LPZ+AMPC+CAM三种药物进行根除的病例中，在治疗前和治疗后2-3个月共28份标本中检测到MNZ和MNZ。我们还通过脉冲场凝胶电泳（PFGE）基因组分析研究了根除失败的原因。在5例根除失败的病例中，治疗前后的基因型匹配。3例在根除前后对3种药剂均敏感；其余2例在治疗前对CAM有原发性耐药。这些病例不能被认为是由于根除而获得耐药性，因此，更多的根除失败的原因不是产生耐药性或再次感染，而是因为没有正确使用根除剂。在研究的第二年，我们使用HpSA ELISA试剂检测粪便抗原，检查幽门螺杆菌感染率的变化，以及常规处理幽门螺杆菌的临床技术人员的感染状况。关于感染率，与10年前相比，各个年龄组的阳性率只有变化。7名常规处理幽门螺杆菌的技术人员中，2名幽门螺杆菌粪便抗原阳性。有报告称，卫生保健人员（如内窥镜医师）的幽门螺杆菌感染率为50%或以上，与此相反，参与幽门螺杆菌检测的细菌学技术人员并未注意到这一现象。第三年，我们用PCR检测了幽门螺杆菌的毒力因子cagA。108株临床分离株中有106株具有cagA；这与95-100%的临床分离株具有cagA的报告一致。这表明拥有cagA可能不能作为幽门螺杆菌发病或预后的指标。少