摘要
目的了解儿童幽门螺杆菌(H.pylori)感染情况及其耐药性,为儿童H.pylori治疗提供参考信息。方法选取2017年1月至2018年10月(男性45例,女性41例)因上消化道不适症状于首都儿科研究所就诊的86名患儿为研究对象,所有患儿行胃镜检查,并使用快速尿素酶试验检测显示H.pylori阳性。入选患儿取胃黏膜样品,使用哥伦比亚琼脂液进行H.pylori培养,阳性培养菌株使用酶生化反应进行鉴定,采用E-test法对分离出的H.pylori菌株进行药敏试验。结果共分离出H.pylori菌株17株,分离阳性率为19.8%(17/86),其中男性和女性患儿H.pylori阳性率分别为22.2%(10/45)和17.1%(7/41),差异无统计学意义(χ^2=0.359,P=0.549)。分离出的17株H.pylori对甲硝唑耐药率最高(70.6%,12/17),其次为克拉霉素(35.3%,6/17)、阿莫西林(23.5%,4/17)、左氧氟沙星(17.6%,3/17)、利福平(11.8%,2/17)和四环素(5.9%,1/17)。其中H.pylori对甲硝唑+克拉霉素双重耐药率为11.8%(2/17);对甲硝唑+阿莫西林双重耐药率为11.8%(2/17);对甲硝唑+左氧氟沙星双重耐药率为5.9%(1/17)。还有1株H.pylori对甲硝唑+克拉霉素+阿莫西林三重耐药,三重耐药率为5.9%(1/17)。结论儿科门诊患儿H.pylori感染阳性率较低,其H.pylori菌株对甲硝唑、克拉霉素和阿莫西林耐药率较高,且观察到双重和多重耐药。应提前了解就诊患儿H.pylori感染情况,根据菌株耐药情况选择个体化疗法,以提高根治率,减少菌株耐药性。
Objectives To understand the infection and drug resistance of Helicobacter pylori(H.pylori)in children and provide information for the treatment.Methods A total of 86 children(45 males and 41 females)who visited Capital Institute of Pediatrics from January 2017 to October 2018 because of upper gastrointestinal discomfort were enrolled.All the patients underwent gastroscopy and were positive in H.pylori urease test.Gastric mucosal specimens were collected and cultured for H.pylori with Columbia agar medium.The positive colonies were identified using enzyme reaction,and the isolated H.pylori strains were subjected to drug sensitivity test using E-test method.Results A total of 17 H.pylori strains were isolated;the positive rate was 19.8%(17/86).The positive rates of H.pylori isolates in male and female children were 22.2%(10/45)and 17.1%(7/41),respectively,without significant difference(χ^2=0.359,P=0.549).The drug resistance rate of H.pylori to Metronidazole was the highest(70.6%,12/17),followed by Clarithromycin(35.3%,6/17),Amoxicillin(23.5%,4/17),Levofloxacin(17.6%,3/17),Rifampicin(11.8%,2/17)and Tetracycline(5.9%,1/17).The double resistance rate of H.pylori was 11.8%(2/17)to Metronidazole/Clarithromycin,11.8%(2/17)to Metronidazole/Amoxicillin,and 5.9%(1/17)to Metronidazole/Levofloxacin.One H.pylori strain had a triple resistance to Metronidazole/Clarithromycin/Amoxicillin,with a resistance rate of 5.9%(1/17).Conclusion The positive rate of H.pylori was low in children.The isolated H.pylori strains showed high resistance rates to Metronidazole,Clarithromycin and Amoxicillin.Double and multi-drug resistance were also observed.The epidemiology of H.pylori infection should be investigated in advance.Individualized therapy should be selected according to the drug resistance to improve eradication rate and reduce clinical drug resistance.
作者
宫幼喆
GONG Youzhe(Capital Institute of Pediatrics,Beijing 100020,China)
出处
《中国微生态学杂志》
CAS
CSCD
2020年第8期908-911,共4页
Chinese Journal of Microecology
基金
首都儿科研究所科研基金(QN-16-04)。
关键词
儿童
幽门螺杆菌
药敏试验
耐药性
Children
Helicobacter pylori
Susceptibility testing
Drug resistance
