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目的了解江西地区胃十二肠疾病患儿幽门螺杆菌(H.pylori)阳性率,及临床分离菌株的耐药性。方法2014年7月至2015年5月195例有上消化道症状患儿行胃镜及黏膜活检,胃黏膜经H.pylori分离培养和鉴定后,采用E-test法检测H.pylori对阿莫西林、克拉霉素和甲硝唑的敏感性,采用K-B法检测H.pylori对呋喃唑酮的敏感性。结果从195例患儿胃黏膜中培养出H.pylori 80株,阳性率为41.0%。在慢性浅表性胃炎、十二指肠球炎、胃溃疡和十二指肠球部溃疡患儿中,H.pylori培养阳性率分别为28.2%、52.0%、30.0%和51.2%。H.pylori菌株对克拉霉素和甲硝唑耐药率分别为25.0%和48.8%,其中对克拉霉素和甲硝唑二重耐药率为10%;出对阿莫西林和呋喃唑酮均敏感。结论 H.pylori感染是儿童上消化道疾病的主要原因之一。江西地区儿童感染H.pylori对甲硝唑和克拉霉素的耐药率较高。
Objective To investigate the positive rate of H.pylori in children with gastroduodenal disease in Jiangxi Province and the drug resistance of clinical isolates. Methods From July 2014 to May 2015, 195 children with upper gastrointestinal symptoms underwent gastroscopy and mucosal biopsy. The gastric mucosa were isolated and identified by H.pylori. E-test was used to detect the effect of H.pylori on amoxicillin , Clarithromycin and metronidazole sensitivity, using KB method to detect H.pylori furazolidone sensitivity. Results 80 strains of H.pylori were cultured from gastric mucosa in 195 children, the positive rate was 41.0%. The positive rate of H.pylori culture in children with chronic superficial gastritis, duodenal inflammation, gastric ulcer and duodenal ulcer were 28.2%, 52.0%, 30.0% and 51.2%, respectively. The drug resistance rates of H.pylori to clarithromycin and metronidazole were 25.0% and 48.8%, respectively, and the rates of double-drug resistance to clarithromycin and metronidazole were 10%; both were sensitive to amoxicillin and furazolidone . Conclusion H.pylori infection is one of the major causes of upper gastrointestinal diseases in children. In Jiangxi province, H.pylori infection rate of metronidazole and clarithromycin was higher in children.