Analysis Of Helicobacter Pylori Infection And Drug Resistance In 1500 Patients With Up-gastric Symptoms

Backgrounds and aimsHelicobacter pylori(Hp)belongs to the microaerophilic gram-negative helicobacter.Since discovered and separated from gastric mucosa in1983,it was found to be associated with the occurrence of most chronic gastritis,gastric ulceration, non-ulcer dyspepsia,gastric cancer and gastric lymphoma.The infection of Hp was spread worldwide,which had high prevalence of 20-50%and 80%in middle aged adults in developed countries and some developing countries.Currently,the diagnosis of Hp was divided into two mainstreams:insertion and non-insertion.The combination of drugs for Hp eradication was recommended,which included proton pump inhibitor or bismuth plus one to three kinds of antibiotics such as clarithromycin,amoxicillin,nitromidazole or tetracycline,lasting more than seven days.With the slathering in antibacterial agents,the drug resistance of Hp has been increased,though with different mechanisms.There were a lot of reports on the drug resistance of Hp from different countries and regions with varied resistance rate and limited sample scale.In this thesis,1500 subjects with different gastrointestinal diseases were investigated on Hp positive rate,resistance rate to six major antimicrobial agents and the predisposing factors for Hp infection,which will provide more detailed data for rational administration in clinical eradication of Hp.Materials and methodsPatients who had the up-gastric symptoms were employed from hospitals around Zhejiang province between Feb 2006 and Mar 2007.There were 813 male and 687 female of total population and aged from 19 to 90.The mucosa near 5 cm to pylorus was biopsied and Hp was separated and cultured.The speculated Hp colony was verified through gram staining and biochemical reactions including urease,catalase and oxidase.The drug resistance of Hp was tested by slip agar diffusion method.ResultsThe Hp positive rates in gastritis,ulcer,duodenitis,gastric carcinoma were 49.96%,33.45%,40.00%and 66.67%in respective.The drug resistance of Hp to amoxicillin,clarithromycin,gentamycin,furaxone,arilin and levofloxacin were 20.66%,16.47%,13.17%,10.33%,96.11%and 1.65%in respective.Hp positive rate in male patients was 39.36%while in female patients was 50.66%,which showed statistical significance(p＜0.01).Besides,there was also significant association between Hp infection and age in patients who were less than 80(p＜0.01).ConclusionsThe overall Hp positive rate in all enrolled subjects was 44.53%with highest of 66.67%in subjects with gastric cancer.The drug resistance of Hp ranked highest of 96.11%in arilin while lowest of 1.65%in levofloxacin.