摘要
目的探讨医院患者幽门螺杆菌感染的分离培养情况及对抗菌药物耐药性,并对相关影响因素进行分析,旨在为临床用药提供参考依据。方法选取2014年1月-2016年1月因消化不良症状于医院行胃镜检查的患者4 052例为研究对象,对其胃窦及胃体部黏膜样本采集后进行幽门螺杆菌培养与鉴定,并采用E-test方法对获得的幽门螺杆菌菌株进行常用抗菌药物的体外敏感性试验,收集患者的年龄、吸烟、饮酒、内镜下诊断等临床资料,单因素和多因素Logistic回归分析患者感染的相关影响因素,采用SPSS 17.0软件对调查数据进行统计分析。结果 4 052例行胃镜检查的患者中1 300例患者标本经幽门螺杆菌培养为阳性,阳性率为32.1%,共分离出1 300株幽门螺杆菌;经药物敏感性分析,幽门螺杆菌对甲硝唑耐药率较高,均>80%,对呋喃唑酮、四环素、阿莫西林,耐药率较低,均<20%;其中对单一抗菌药物耐药的菌株占30.5%,对多种抗菌药物耐药的菌株占69.5%;多因素Logistic分析结果显示,年龄≥60岁、饮酒及萎缩性胃炎是患者幽门螺杆菌感染的影响因素(P<0.05)。结论本地区幽门螺杆菌的感染率较高,影响患者发生幽门螺杆菌感染的相关因素包括年龄、饮酒、萎缩性胃炎,临床上应加强对此类患者的检查与治疗。
OBJECTIVE To explore the isolation and cultivation of Helicobacter pylori infection from the patients in the hospital and the antimicrobial drug resistance,and to analyze the related influencing factors,so as to provide reference basis for clinical medication.METHODS A total of 4052 cases of patients underwent gastroscopy in the hospital for dyspepsia symptoms from Jan.2014 to Jan.2016 were selected as the research sujects.The mucosa samples of the gastric antrum and gastric body were collected for cultivation and identification of H.pylori,and the E test was used to test the susceptibility of the H.pylori strains to commonly used antimicrobials in vitro.The patients＇ clinial data such as age,smoking history,drinking history,and endoscopic diagnosis results were collected.The related factors affecting the infections were analyzed using univariate and multivariate logistic regression analysis.Statistical analysis of the survey data was conducted using SPSS 17.0 software.RESULTSIn the4052 cases of mucosa biopsy specimens,1300 cases were positive with H.pylori culture,and the positive rate was 32.1%.The drug sensitivity analysis showed high resistance of H.pylori strains to metronidazole（〉80%）,and low resistance to clarithromycin,levofloxacin,furazolidone,tetracycline and amoxicillin（〈20%）.Strains resistant to a single antimicrobial drug accounted for 30.5%,and multidrug-resistant strains accounted for 69.5%.The multivariate Logistic analysis showed that the influencing factors of H.pylori infection include age≥60 years old,drinking history and atrophic gastritis（P〈0.05）.CONCLUSIONThe infection rate of H.pylori in region is high,and the influencing factors of H.pylori infection include age,drinking history and atrophic gastritis.Cinical examination and treatment should be strengthened for these patients.
作者
周雄杰
吕志刚
柳家红
林玄威
ZHOU Xiong-jie;LYU Zhi-gang;LIU Jia-hong;LIN Xuan-wei(People＇s Hospital of Fenghua District in Ningbo City,Ningbo,Zhejiang 315500,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第16期2490-2493,共4页
Chinese Journal of Nosocomiology
基金
浙江省中医药科技计划基金资助项目(2009B620017)
关键词
幽门螺杆菌
感染
抗菌药物
耐药性
Helicobacter pylori
Infection
Antimicrobial agents
Drug resistance
