临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (10): 903-.doi: 10.3969 j.issn.1000-3606.2014.10.002

• 消化系统疾病专栏 • 上一篇    下一篇

儿童结节性胃炎幽门螺杆菌耐药性分析

王玉环1,黄瑛1,王传清2,吴婕1   

  1. 复旦大学附属儿科医院 1. 消化科,2. 检验科 ( 上海 201102)
  • 收稿日期:2014-10-15 出版日期:2014-10-15 发布日期:2014-10-15
  • 通讯作者: 黄瑛 E-mail:yhuang815@163.com

Drug resistance of Helicobacter pylori in nodular gastritis in children 

 WANG Yuhuan1, HUANG Ying1, WANG Chuanqing2, WU Jie1   

  1. 1.Department of Gastroenterology, 2.Department of Clinical Laboratory, Children’s Hospital of Fudan University, Shanghai 201102, China
  • Received:2014-10-15 Online:2014-10-15 Published:2014-10-15

摘要: 目的 分析儿童结节性胃炎幽门螺杆菌(H.pylori) 的耐药情况,探讨H.pylori耐药菌株的抗生素合理使用方法。方法 2013年1月至2014年6月因上消化道症状就诊行胃镜检查的结节性胃炎患儿473例,收集患儿的胃窦黏膜2块,分别行H.pylori快速尿素酶试验和培养。用琼脂稀释法和E-test法检测H.pylori对阿莫西林、克拉霉素、甲硝唑、莫西沙星和左氧氟沙星的耐药情况。结果 473例结节性胃炎患儿,258例H.pylori培养阳性,H.pylori菌株对阿莫西林、克拉霉素、甲硝唑、莫西沙星、左氧氟沙星的耐药率分别为6.2%、34.9%、49.2%、8.9%、5.0%。对克拉霉素和甲硝唑双重耐药率为23.3%。473例患儿中,405例家长有H.pylori感染。结论 结节性胃炎是儿童H.pylori感染的一种特殊征象。H.pylori感染有明显家族聚集性。儿童结节性胃炎H.pylori对阿莫西林的耐药率较低,应作为根除H.pylori的主要药物;克拉霉素的耐药率较高,在H.pylori高耐药地区,应在药敏结果指导下实施三联抗H.pylori治疗。

Abstract: Objective To analyze the drug resistance of Helicobacter pylori (H.pylori) in nodular gastritis in children and to further explore the rational use of antibiotics for drug-resistant H.pylori strains. Methods A total of 473 children with upper gastrointestinal symptoms undergoing gastroscopy from January 2013 to June 2014 in our hospital were enrolled. Two pieces of gastric antral mucosa in children with nodular gastritis were collected for H.pylori rapid urease test and H.pylori culture. The
resistance of H.pylori to amoxicillin, clarithromycin, metronidazole, moxifloxacin and levofloxacin was detected by agar dilution method and E-test. Results In 473 cases of nodular gastritis, 258 cases were H.pylori culture-positive. The resistance rate of H.pylori isolates to amoxicillin, clarithromycin, metronidazole, moxifloxacin, levofloxacin was 6.2%, 34.9%, 49.2%, 8.9% and 5.0%, respectively. Dual resistance to clarithromycin and metronidazole was 23.3%. Moreover, 405 cases had a family history of H.pylori infection. Conclusions Nodular gastritis is a special sign of H.pylori infection in children. H.pylori infection has obvious familial
aggregation. The low resistance rate of H.pylori to amoxicillin in children with nodular gastritis indicates that amoxicillin can be used as the main drug for eradication of H.pylori. Meanwhile, clarithromycin should be applied according to the drug sensitive test due to high resistance rate of H.pylori to clarithromycin.