中国幽门螺杆菌耐药情况研究
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摘要
目的分析中国幽门螺杆菌(Helicobacter pylori,H.pylori)对多种抗生素的耐药现状,探讨耐药率的变化趋势及耐药率的地区差异。方法从中国知网及万方数据库检索并筛选H.pylori对各种抗生素耐药的文献,计算不同地区及不同时间的H.pylori耐药率。结果截止到2015年8月,共检索到30篇符合要求的关于中国H.pylori耐药情况的文献。分析发现,H.pylori对克拉霉素总体耐药率为20.8%(95%CI:18.2%~23.7%),耐药率自1999年的15.4%上升到2014年的29.6%,以平均每年0.9%的速度增长,耐药率与时间呈线性正相关(R2=0.6031,P<0.001);南方耐药率与北方相以。H.pylori对左氧氟沙星总体耐药率为8.9%(95%CI:5.6%~13.7%),耐药率由2006年的2.9%上升到2014年的18.9%,平均每年升高约1.8%,耐药率与时间呈线性正相关(R2=0.8506,P<0.001);与北方相比,南方地区耐药率较低,但差异无统计学意义(P>0.05)。H.pylori对甲硝唑总体耐药率为83.7%(95%CI:75.0%~89.8%),以2.4%的增长速度,由1994年的26.3%升高为2014年的77.1%;南方地区耐药率明显高于北方。结论近年来,我国H.pylori对多种抗生素耐药率呈不断上升趋势,临床上减少抗生素滥用并开展抗生素敏感试验可以阻止耐药率升高趋势。
Objective To investigate the resistance rate of Helicobacter pylori( H. pylori) to antibiotics at different times and in different areas of China. Methods A literature search was performed to identify eligible studies on H. pylori resistance to antibiotics in CNKI and Wanfang database. The resistance rates of H. pylori to different antibiotics at different times and in different areas were calculated. Results By Aug. 2015,a total of 30 eligible studies on H. pylori antibiotic resistance had been identified within the time span of 1994 to 2014. Analysis showed that the total resistance rate of H. pylori to Clarithromycin was 20. 8%( 95% CI: 18. 2%-23. 7%). The resistance rate raised from 15. 4% in1999 to 29. 6% in 2014,with an annual growth rate of 0. 9%. It showed a linear correlation with time( R2= 0. 6031,P < 0. 001). The resistance rate in southern China was similar to northern China. The total resistance rate to Levofloxacin was 8. 9%( 95% CI: 5. 6%-13. 7%). The resistance rate raised from 2. 9% in 2006 to 18. 9% in 2014,with an annual growth rate of 1. 8%. A linear correlation with time was demonstrated( R2= 0. 8506,P < 0. 001). The resistance rate in southern China was lower than that in northern China,but there was no statistical significance( P > 0. 05).The total resistance rate of H. pylori to Metronidazole was 83. 7%( 95% CI: 75. 0%-89. 8%). The resistance rate raised from 26. 3% in 1994 to 77. 1% in 2014,with an annual growth rate of 2. 4%. The resistance rate in southern China was significantly higher than that in northern China. Conclusion The resistance rate of H. pylori to antibiotics tends to increase in recent years in China. Avoiding antibiotics abuse and taking a susceptibility test before treatment will be a good way to prevent the rising tendency of the resistance rate.
Objective To investigate the resistance rate of Helicobacter pylori( H. pylori) to antibiotics at different times and in different areas of China. Methods A literature search was performed to identify eligible studies on H. pylori resistance to antibiotics in CNKI and Wanfang database. The resistance rates of H. pylori to different antibiotics at different times and in different areas were calculated. Results By Aug. 2015,a total of 30 eligible studies on H. pylori antibiotic resistance had been identified within the time span of 1994 to 2014. Analysis showed that the total resistance rate of H. pylori to Clarithromycin was 20. 8%( 95% CI: 18. 2%-23. 7%). The resistance rate raised from 15. 4% in1999 to 29. 6% in 2014,with an annual growth rate of 0. 9%. It showed a linear correlation with time( R2= 0. 6031,P < 0. 001). The resistance rate in southern China was similar to northern China. The total resistance rate to Levofloxacin was 8. 9%( 95% CI: 5. 6%-13. 7%). The resistance rate raised from 2. 9% in 2006 to 18. 9% in 2014,with an annual growth rate of 1. 8%. A linear correlation with time was demonstrated( R2= 0. 8506,P < 0. 001). The resistance rate in southern China was lower than that in northern China,but there was no statistical significance( P > 0. 05).The total resistance rate of H. pylori to Metronidazole was 83. 7%( 95% CI: 75. 0%-89. 8%). The resistance rate raised from 26. 3% in 1994 to 77. 1% in 2014,with an annual growth rate of 2. 4%. The resistance rate in southern China was significantly higher than that in northern China. Conclusion The resistance rate of H. pylori to antibiotics tends to increase in recent years in China. Avoiding antibiotics abuse and taking a susceptibility test before treatment will be a good way to prevent the rising tendency of the resistance rate.
引文
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