一个或多个根除失败后的二次抗生素耐药性:一个基因型便分析研究研究
Giuseppe Losurdo1, Martino Mezzapesa1, Ilaria Ditonno1
1Section of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy.
Antibiotics (Basel, Switzerland)
|April 26, 2024
概括
杆菌 (H. pylori) 的二次抗生素耐药性是一个越来越令人担忧的问题. 这项研究发现,虽然二次耐药性率不高,但先前暴露于克拉里胺显著增加了对这种特定抗生素的耐药性.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 杆菌 (H. pylori) 的抗生素耐药性是治疗失败的主要驱动因素.
- 重复的根除尝试增加了发展二次抗生素耐药性的可能性.
研究的目的:
- 在意大利南部有治疗失败史的患者中调查H. pylori感染中基因型二次抗生素耐药性的患病率和模式.
- 评估对关键抗生素的耐药性,包括清素,阿莫西西林,甲尼达,勒沃素和四环素.
主要方法:
- 一组由50名H. pylori患者组成的队列,至少有一次之前的治疗失败,提供了便样本.
- 通过RT-PCR提取和放大细菌DNA.
- 使用高分辨率的化曲线分析来检测基因型对克拉里素,阿莫西西林,甲尼达,勒沃素和四环素的耐药性.
主要成果:
- 观察到的二次耐药率为16%的克拉里素,18%的美特罗尼达,14%的阿莫西西林,14%的勒沃素和2%的四环素.
- 显著比例的克拉里素耐药病例 (62.5%) 曾经接受过基于克拉里素的治疗.
- 同样,33.3%的美特龙醇耐药病例先前接触过以美特龙醇为基础的疗法.
结论:
- 二次性H. pylori抗生素耐药性,虽然在这个队列中并不特别高,但存在.
- 以前接触过克拉胺素似乎是发展克拉胺素耐药性的强有力的预测因素.
- 了解耐药性模式对于优化H. pylori根除策略至关重要.
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