刘付俊业 李俊达 胡桂花

    [摘要] 目的 调查幽门螺杆菌(Hp)对6种常用抗生素的继发耐药情况，为临床医师合理选用抗生素、合理制订根除Hp治疗的补救方案提供依据。 方法 随机选取深圳市龙华区人民医院Hp根除治疗后行13C呼气试验阳性的患者120例，胃镜下于胃窦小弯侧及胃体小弯侧各取黏膜一块行Hp分离培养，对获得的Hp菌株进行阿莫西林、克拉霉素、呋喃唑酮、多西环素、左氧氟沙星、甲硝唑的药物敏感性试验。 结果 成功分离培养出97株Hp，快速尿素酶试验阳性者均成功培养出Hp，Hp培养阳性率与性别、年龄、13C呼气试验无相关性(P > 0.05)。Hp对甲硝唑、阿莫西林、克拉霉素、呋喃唑酮的继发耐药率分别为100.0%、75.2%、30.9%和1.0%，未检出对多西环素或左氧氟沙星耐药的菌株;单药耐药率为14.4%，双重耐药率为65.0%，三重耐药率为19.6%，四重耐药率为1.0%。Hp继发耐药率与性别、年龄、13C呼气试验结果无相关性(P > 0.05)。 结论 Hp根除治疗的补救方案应在药敏试验指导下进行个体化根除治疗，快速尿素酶试验阳性是提高Hp培养阳性率的可靠方法。

    [关键词] 幽门螺杆菌;培养;继发耐药;13C呼气试验

    [中图分类号] R978.1? ? ? ? ? [文獻标识码] A? ? ? ? ? [文章编号] 1673-7210(2020)03(b)-0060-04

    [Abstract] Objective To investigate the secondary drug resistance of Helicobacter pylori (Hp) to six commonly used antibiotics， and to provid a basis for clinicians to rationally choose antibiotics and rationally formulate remedial plans for eradication of Hp. Methods A total of 120 patients with positive 13C breath test after Hp eradication were randomly selected from the Longhua District People′ Hospital of Shenzhen City. Gastroscopy was performed on the mucosa of the gastric antrum and on the minor curvature of the gastric body for Hp isolation and culture. The obtained Hp strain was tested for the drug sensitivity of Amoxicillin ......