治疗失败是Helicobacter pylori耐药性的发展的一个关键因素
Jinliang Xie1,2, Jianxiang Peng1,2, Dingwei Liu1,2
1Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China.
Helicobacter
|May 23, 2024
概括
在Helicobacter pylori感染中,治疗失败显著增加了抗生素耐药性,特别是对阿莫西西林,克拉里思罗米辛,勒沃素和美特罗尼达的耐药性. 成功的第一线根除对于防止耐药性升级和治疗挑战至关重要.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- Helicobacter pylori 根除失败是一个越来越令人担忧的问题,影响治疗疗效,并导致抗生素耐药性.
- 了解治疗史和耐药性模式之间的关系对于有效的H. pylori管理至关重要.
研究的目的:
- 评估先前治疗失败如何影响H. pylori抗生素耐药率.
- 分析治疗失败后最小抑制度 (MIC) 分布和耐药性概况的变化.
主要方法:
- 对860个初级和247个二级H. pylori分离物的回顾性分析.
- 对关键根除药物进行抗生素敏感性测试:阿莫西西林,甲尼达,克拉里思罗米,勒沃素,法拉佐利,四环素和利法辛.
- 收集患者人口统计数据和治疗方案.
主要成果:
- 与多种抗生素的初级分离物相比,二次分离物显示出明显更高的耐药率.
- 观察到阿莫西西林,甲尼达,克拉利思罗米辛和莱沃素的耐药性率和MIC值显著增加,并累积治疗失败.
- 多抗药性 (MDR) H. pylori 的患病率从初级分离的17.79%大幅上升到二级分离的63.16%.
结论:
- 一线H.pylori治疗失败导致对阿莫西西林,克拉里思罗米辛,勒沃弗洛克萨辛和美特罗尼达的耐药性迅速增加,以及MICs升高.
- 强调成功的第一线根除对于缓解不断升级的抗生素耐药性的至关重要.
- 强调在管理H. pylori感染时需要仔细考虑治疗史.
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