为探讨复旦大学附属华东医院(以下简称本院)分离培养的幽门螺杆菌(Helicobacter pylori,H.pylori)的耐药性、毒力和感染特征与其生物膜形成能力的相关性,收集2014年12月—2015年6月于本院消化内镜中心的胃活检组织标本及相应临床病例资料,分离培养获得幽门螺杆菌,分析菌株的耐药性、毒力基因型、临床病例特征.结果显示,从胃活检组织样本中共分离培养28株幽门螺杆菌,对左氧氟沙星(levofloxacin,LEV)、甲硝唑(metronidazole,MTZ)和克拉霉素(clarithromycin,CLA)的耐药率分别为32%、75%和11%,未发现阿莫西林(amoxicillin,AMX)耐药.单一药物耐药17株(17/28,61%),双重耐药10株(10/28,36%).毒力基因cagA、oipA和vacAs1检出率为100%,未检出vacAs2.基因型vacAs1 m1占39%(11/28),vacAs1 m2占61%(17/28);iceA1占54%(15/28),iceA2占21%(6/28),iceA1 A2占25%(7/28);dupA+占36%(10/28).28株菌株均能形成生物膜,但能力不尽相同.单因素及独立样本t检验分析显示,45~59岁、iceA1+dupA-基因型和甲硝唑敏感菌株形成生物膜的能力较强.结果提示,本院分离的幽门螺杆菌对甲硝唑耐药率最高,双重耐药不容忽视.菌株主要毒力基因型为cagA、oipA、vacAs1 m2.幽门螺杆菌的生物膜形成能力与患者年龄有关,45~59岁组较强;携带毒力基因iceA1的菌株生物膜形成能力强;d u pA基因型及甲硝唑耐药与菌株生物膜形成呈负相关.%To investigate the drug resistance and virulence of Helicobacter pylori (H . pylori) strains ,and explore their relationship with the infection characteristics and biofilm formation ability , gastric mucosa biopsy samples and related clinical data were collected from Huadong Hospital Affiliated to Fudan University between December 2014 and June 2015 . H . pylori strains isolated from these clinical samples were subjected to drug resistance assay ,virulence gene assay and biofilm-forming assay .Twenty-eight H . pylori strains were acquired . The resistance rates to levofloxacin (LEV ) , metronidazole (MTZ ) , clarithromycin (CLA) and amoxicillin (AMX) were 32% ,75% ,11% and 0 ,respectively .The single and double resistance rates were 61% (17/28) and 36% (10/28) ,respectively .The detection rates of virulence genes cagA ,oipA and vacAs1 were 100% ,and no vacAs2 was detected .vacAs1 m2 genotype accounted for 61% (17/28) ,followed by vacAs1 m1 (11/28 ,39% ) .The prevalence rates of iceA1 , iceA2 and iceA1 iceA2 were 54% (15/28) ,21% (6/28) ,25% (7/28) ,respectively .The detection rate of dupA was 36%(10/28 ) . The biofilm-forming ability of 28 strains varied . Single factor and independent sample t test analysis showed that strains isolated from 45-59 years old patients ,iceA1+ dupA - genotype ,metronidazole-sensitive strains could form stronger biofilm . In conclusion , the resistance rate of H . pylori to metronidazole was highest in single resistance ,and the double resistance should not be neglected .The main genotypes of H . pylori isolates were cagA , oipA , vacAs1 m2 . The H . pylori biofilm-forming ability is related to the age of patients .Specifically ,strains isolated from the age 45-59 group have stronger biofilm-forming ability than those obtained from other age groups .In addition ,isolates carrying the virulence gene iceA1 have strong biofilm-forming ability .And there is a negative correlation between dupA genotype or metronidazole resistance and the biofilm-forming ability of the H . pylori isolates .
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