中国幽门螺杆菌(Hp)感染患者原发抗生素耐药的一项前瞻性多中心研究

目录
展望


按照当前的耐药率,优先考虑的事情应该是获 得新的药物和/或改善抗生素耐药性的检测 方法。 已经建议使用一种更简单方便的方法来获取 幽门螺杆菌,而且从粪便样本中进行抗生素耐 药性的分子检测也取得了很大的进展，并且 展示出它将是一spective multi-region study on primary antibiotic resistance of Helicobacter pylori strains isolated from Chinese patients
目录
研究结果
1.
2.
整体上，甲硝哒唑的耐药率最高(403, 67.2%), 其次是克拉霉素(225, 37.5%), 左氧氟沙星 (201, 33.5%)、利福平(85, 14.2%),阿莫西林 (41, 6.8%)以及四环素(21, 3.5%); 有16.3%的分离菌株对所有被检测的抗生素均敏 感,其次是单耐药(34.2%),双耐药(27.0%)、三 重耐药(16.8%)、四重耐药(4.7%)、五重耐药 (0.7%)和六重耐药(0.3%)；
目录
Thanks for your attention!
目录
目录
Prospect


With the current rates of resistance, the priority would be obtaining new drugs and/or improved methods for the detection of resistance. The use of a more accessible and easier method to obtain H. Pylori has already been suggested, and progresses in the molecular detection of resistance from fecal samples also represent a very promising line of research.
中国幽门螺杆菌（Hp）感染患者原发耐药 的一项前瞻性多中心研究
目录
简介

2014年9月Dig Liver Dis发表了北京大学第三医院消化科 周丽雅教授牵头的一项国内5家中心共同完成的临床试验 “中国幽门螺杆菌感染患者原发抗生素耐药的一项前瞻 性多中心研究”(Song Z, Zhang J, He L, Chen M, Hou X, Li Z, Zhou L. Prospective multi-region study on primary antibiotic resistance of Helicobacter pylori strains isolated from Chinese patients. Dig Liver Dis 2014; 46: 1077-1081)，系统地介绍了我国各地区幽门螺杆菌(Hp) 抗生素耐药的情况，以及总体耐药情况，并深人探讨了 在我国以及其他一些抗生素耐药率很高的地区，获取关 于Hp耐药的全面的、最新的信息对选择最优的根除方案 的必要性。
目录
Conclusions

Helicobacter pylori resistance to commonly used antibiotics in China is a very serious issue, due to the high resistance rate and general multiple resistance.
目录
Aims

To determine the resistance patterns of Helicobacter pylori strains isolated from dyspeptic patients.
目录
Methods

This is a prospective, multicentre, cross-sectional, observational study. Helicobacter pylori cultures were successful in 600 patients (never receiving eradication therapy) from Northern, Eastern, Middle, and Southern regions between 2008 and 2012. Resistance to amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, and rifampicin was determined by Epsilometer test.
目录
研究背景

迫切需要大规模多中心的研究提供有关幽门螺杆 菌抗生素耐药情况的全面的和最新的信息，这些 信息对选择最优的根除方案是至关重要的。
目录
研究目的

本研究的主要目的是确定从消化不良患者 体内分离菌株的幽门螺杆菌的抗菌药耐药 模式。
目录
研究方法

这是一个前瞻性,多中心、横断面观察研究。在 2008年和2012年之间，成功的培养了来自我国 北部、东部、中部和南部地区的600位患者(从 未接受根除治疗)体内的幽门螺杆菌。阿莫西林, 克拉霉素,甲硝哒唑、左氧氟沙星、四环素和利 福平的耐药情况是由E试验测得的。
目录
Background

Large-scale multi-region studies are urgently needed to provide comprehensive and up-todate information on the antibiotic resistance of Helicobacter pylori that is critical for selecting the most optimal eradication regimens.
目录
研究结果
3.
4.
影响抗生素耐药性的独立危险因素分别是：性 别(左氧氟沙星)、年龄(左氧氟沙星)和镜下表 现(克拉霉素、甲硝哒唑和左氧氟沙星); 在对克拉霉素耐药的分离菌株中,分别有75.6% 的菌株同时对甲硝唑耐药以及48.0%的菌株同时 对左氧氟沙星耐药。
目录
结论

由于抗生素耐药率高以及普遍的多重耐药， 幽门螺旋杆菌对常用抗生素具有耐药性在中 国是一个非常严重的问题。
目录
Song Z, Zhang J, He L, Chen M, Hou X, Li Z, Zhou L. Prospective multi-region study on primary antibiotic resistance of Helicobacter pylori strains isolated from Chinese patients. Dig Liver Dis 2014; 46: 1077-1081.
目录
Results
1.
2.
The overall resistance rate was highest for metronidazole (403, 67.2%), followed by clarithromycin (225, 37.5%), levofloxacin (201, 33.5%), rifampicin (85, 14.2%), amoxicillin (41, 6.8%), and tetracycline (21, 3.5%). There were 16.3% isolates susceptible to all tested antibiotics, followed by mono-resistance (34.2%), double resistance (27.0%), triple resistance (16.8%), quadruple resistance (4.7%), quintuple resistance (0.7%) and sextuple resistance (0.3%).
目录
Results
3.
4.
Independent factors influencing antibiotic resistance were gender (to levofloxacin), age (to levofloxacin), and endoscopic finding (to clarithromycin, metronidazole, and levofloxacin). Among the clarithromycin-resistant isolates, 75.6% and 48.0% were also resistant to metronidazole and levofloxacin, respectively.