摘要
目的:探讨四川省地矿局405医院(以下简称"我院")幽门螺杆菌(helicobacter pylori,Hp)对6种常用抗菌药物的耐药性及其变化趋势,为临床合理用药提供依据。方法:随机抽选2013、2016年我院行胃镜检查的消化性溃疡患者各1 000例,对合计2 000例患者的标本进行Hp培养,对分离培养出的Hp分别进行左氧氟沙星、克拉霉素、呋喃唑酮、庆大霉素、阿莫西林和甲硝唑的药物敏感试验。结果:2 000例患者的标本中,分离培养出Hp 699株。Hp对左氧氟沙星、克拉霉素的耐药率呈上升趋势,分别从2013年的19.31%、24.32%升至2016年的32.05%、30.76%;Hp对庆大霉素、阿莫西林的耐药率相对较低且趋于稳定;Hp对呋喃唑酮的耐药率一直较低;Hp对甲硝唑的耐药率相对较高,且呈上升趋势。对2013、2016年Hp对抗菌药物二联用药的耐药率进行比较,结果显示,Hp仅对阿莫西林+庆大霉素、阿莫西林+呋喃唑酮和庆大霉素+呋喃唑酮联合应用的耐药率趋于稳定,差异均无统计学意义(P>0.05);Hp对其他二联用药的耐药率呈上升趋势,差异均有统计学意义(P<0.05)。结论:Hp对庆大霉素、阿莫西林的耐药率相对较低,对呋喃唑酮的耐药性一直较低,上述3药具有良好的抗Hp效果,推荐使用,同时应注意监测不良反应。
OBJECTIVE： To investigate the resistance and variation tendency of Helicobacter pylori（ Hp） to 6 kinds of commonly used antibiotics in 405 Hospital of Sichuan Provincial Bureau of Geology and Mineral Resources（ hereinafter referred to as ＂our hospital＂）,so as to provide reference for rational drug application in clinic.METHODS： 1 000 patients undergoing gastroscopy each from 2013 and 2016 were randomly extracted from our hospital,totally 2 000 specimens were cultured for Hp. Drug sensitivity test was conducted on levofloxacin,clarithromycin,furazolidone,gentamicin,amoxicillin and metronidazole. RESULTS： Of the 2 000 specimens,699 cases of Hp were obtained. The resistance of Hp to levofloxacin and clarithromycin was in an increasing tendency,respectively increased from 19. 31% and 24. 32% in 2013 to 32. 05% and 30. 76% in 2016. The resistant strains of Hp to gentamicin and amoxicillin were relatively low and tended to be stable. The resistance of Hp to furazolidone was relatively low. And the resistance of Hp to metronidazole was also relatively high and showed an increasing trend. After comparison of resistance of Hp to duplex application of antibiotics between 2013 to 2016,the resistance of Hp to amoxicilli ＋ gentamicin,amoxicilli ＋ furazolidone,gentamicin ＋ furazolidone was in an stable tendency,without any statistical significance（ P〉0. 05）; yet the resistance of Hp to other duplex application was in an increasing tendency,with statistically significant difference（ P〈0. 05）. CONCLUSIONS： Both the drug resistances of Hp to gentamicin and amoxicillin are relatively low,and with low drug resistance to furazolidone,all three drugs effect well in anti-Hp,which is recommended for application,while monitoring on adverse drug reactions should not be ignored.
出处
《中国医院用药评价与分析》
2018年第2期274-275,279,共3页
Evaluation and Analysis of Drug-use in Hospitals of China
关键词
幽门螺杆菌
抗菌药物
耐药
Helicobacter pylori
Antibiotic
Drug resistance
