关键词: 幽门螺杆菌, 抗菌药物, 儿童, 耐药性

Abstract:

Objective To investigate the drug resistance of Helicobacter pylori （Hp） to 5 antimicrobial agents,which are commonly used in eradication therapy among children in Shanghai.Methods Gastric mucosa biopsy specimens were collected from pediatric patients who had upper gastrointestinal symptoms,and were diagnosed as having Hp infection by rapid urease test. Hp was determined for drug susceptibility by Kirby-Bauer method. All pediatric patients were classified according to sex and age [preschool-age（0-6 years old）and school-age（7-15 years old）],and the drug resistance rates of Hp to metronidazole,clarithromycin,amoxicillin,levofloxacin and moxifloxacin among these groups were compared.Results A total of 359 isolates of Hp were isolated from 743 pediatric patients. The positive rate was 48.3%. The drug resistance rates to metronidazole,clarithromycin,amoxicillin,levofloxacin and moxifloxacin were 49.9%,36.8%,5.3%,5.6% and 7.8%,respectively. No statistical significance in drug resistance rates to the 5 antimicrobial agents was found between boys and girls（P>0.05）. The drug resistance rates of isolates from preschool-age group to metronidazole and amoxicillin（74.1% and 11.1%） were higher than those from school-age group（42.8% and 3.6%,P=0.000 and 0.008）,while isolates against clarithromycin showed an inverse pattern （22.2% in preschool-age group and 41.0% in school-age group,P=0.002）. Conclusions The drug resistance rates of Hp among children in Shanghai are high to metronidazole and clarithromycin. However,the drug resistance rates are low to amoxicillin,levofloxacin and moxifloxacin. Therefore,drug susceptibility should be determined before the 1st time therapy．

Key words: Helicobacter pylori, Antimicrobial agents, Children, Drug resistance