Eradication Treatment of Helicobacter pylori Infection Based on Molecular Pathologic Antibiotic Resistance
Eradication Treatment of Helicobacter pylori Infection Based on Molecular Pathologic Antibiotic Resistance
复制标题
DOI：
10.2147/idr.s232169
复制
发表时间：
2020-01-01
影响因子：
3.9
通讯作者：
Chen, Huang
中科院分区：
文献类型：
--
作者：
Gao, Chun;Du, Shi-Yu;Chen, Huang
背景：不幸的是，幽门螺杆菌（H。幽门螺杆菌）的治疗近年来明显减少，主要原因是抗生素耐药性。我们的研究旨在确定H.方法：回顾性分析261例幽门螺杆菌感染患者的临床资料，其中首次治疗组111例（首次治疗组），铋剂四联治疗失败组150例（再次治疗组）。采用Real-time PCR和常规PCR及测序方法检测耐药性。根据意向治疗（ITT）和符合方案（PP）比较两组的根除率（ER）。111例初治患者对阿莫西林、克拉霉素、氟喹诺酮和四环素的耐药率分别为5.5%、42.1%、41.7%和12.9%; 150例复治患者中，阳性率分别为70.7%和30.0%。ITT和PP分析的ER为92.79%（95% CI，87.98- 97.60%，n=111）和98.10%（95% CI，95.48- 100%，n=105），首次治疗患者和90.67%再治疗组的阳性率为95.10%（95%CI，86.01- 95.32%，n=150），再次治疗组的阳性率为95.10%（95%CI，91.57- 98.64%，n=143）。两组患者的ER无显著性差异，未发现严重不良事件。基于分子病理学抗生素耐药性的幽门螺杆菌根除治疗在首次和再次治疗的患者中均显示出良好的疗效和安全性。
Background: Unfortunately, the eradication rate of Helicobacter pylori (H. pylori) treatment is markedly decreasing in recent years and the major reason is antibiotic resistance. Our study was designed to determine the effect and safety of H. pylori eradication treatment based on the molecular pathologic antibiotic resistance.Methods: 261 patients were analyzed retrospectively, including 111 patients who were treated for the first time (one group as First-treated) and 150 patients who failed at least once in bismuth quadruple therapy (another group as Re-treatment). Antibiotic resistance was examined by Real-time PCR detection and conventional PCR and sequencing method. The eradication rate (ER) was compared per intention to treat (ITT) and per protocol (PP) between the two groups.Results: The resistance rates to amoxicillin, clarithromycin, fluoroquinolone and tetracycline were 5.5%, 42.1%, 41.7% and 12.9% in the 111 first-treated patients, and 11.7%, 79.7%, 70.7% and 30.0% in the 150 re-treatment patients. The ERs in the ITT and PP analyses were 92.79% (95% CI, 87.98-97.60%, n=111) and 98.10% (95% CI, 95.48-100%, n=105), respectively, in the first-treated patients and 90.67% (95% CI, 86.01-95.32%, n=150) and 95.10% (95% CI, 91.57-98.64%, n=143), respectively, in the re-treatment patients. No significant differences were shown in the ERs between two group patients, and no serious adverse events were found.Conclusion: H. pylori eradication treatment based on molecular pathologic antibiotic resistance showed good effect and safety in both first and re-treated patients.