한국인 소아에서 분리한 Helicobacter pylori 균주의 항균제 내성률
Antimicrobial Resistance of Helicobacter pylori Isolated from Korean Children
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초록
Purpose: The antimicrobial resistance of Helicobacter pylori is one of the critical factors in failure of eradication therapy. The purpose of this study was to evaluate antimicrobial resistance of H. pylori in Korean children. Methods: Gastric mucosal specimens for H. pylori were obtained from children with dyspepsia who were cared for at Asan Medical Center Children’s Hospital in Seoul, Korea between 2003 and 2009. Antimicrobial resistance tests were performed using the disk diffusion method for clarithromycin and amoxicillin and the E-test for metronidazole and tetracycline. Most children with H. pylori infections were treated using triple therapies. Results: Thirty-three children had positive H. pylori cultures, although a resistance test was only performed in 28 patients. Resistant strains were found in 9 children (32.1%). The resistance rates to clarithromycin and metronidazole were 25% and 17.8%, respectively. There was no resistance to amoxicillin or tetracycline. The resistance rates decreased from 44.4% (2003∼2006) to 26.3% (2006∼2009) during the study period. Conclusion: Korean children demonstrated relatively high antimicrobial resistance to H. pylori in this study. However, there was a temporarily decreasing trend during the study period. A larger multi-regional study may be needed to determine the optimal antimicrobial treatment for pediatric patients infected with H. pylori. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 45∼51)
Abstract
Purpose: The antimicrobial resistance of Helicobacter pylori is one of the critical factors in failure of eradication therapy. The purpose of this study was to evaluate antimicrobial resistance of H. pylori in Korean children. Methods: Gastric mucosal specimens for H. pylori were obtained from children with dyspepsia who were cared for at Asan Medical Center Children’s Hospital in Seoul, Korea between 2003 and 2009. Antimicrobial resistance tests were performed using the disk diffusion method for clarithromycin and amoxicillin and the E-test for metronidazole and tetracycline. Most children with H. pylori infections were treated using triple therapies. Results: Thirty-three children had positive H. pylori cultures, although a resistance test was only performed in 28 patients. Resistant strains were found in 9 children (32.1%). The resistance rates to clarithromycin and metronidazole were 25% and 17.8%, respectively. There was no resistance to amoxicillin or tetracycline. The resistance rates decreased from 44.4% (2003∼2006) to 26.3% (2006∼2009) during the study period. Conclusion: Korean children demonstrated relatively high antimicrobial resistance to H. pylori in this study. However, there was a temporarily decreasing trend during the study period. A larger multi-regional study may be needed to determine the optimal antimicrobial treatment for pediatric patients infected with H. pylori. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 45∼51)
참고문헌 (33)
- NIH Consensus Conference, "Helicobacter pylori in peptic ulcer disease. NIH consensus development panel on Helicobacter pylori in peptic ulcer disease", JAMA, 272, pp.65~69 (1994)
- Dohil R, "Gastritis and gastropathy of childhood", J Pediatr Gastroenterol Nutr, 29, pp.378~394 (1999)
- Taylor DN, "The epidemiology of Helicobacter pylori infection", Epidemiol Rev, 13, pp.42~59 (1991)
- Gottrand F, "Helicobacter pylori infection in early infancy", Lancet, 340, pp.495~ (1992)
- Rhee HS, "Endoscopic and pathologic analysis of pediatric Helicobacter pylori gastritis", Korean J of Gastroenterol, 36, pp.10~19 (2000)
- Drumm B, "Association of Campylobacter pylori on the gastric mucosa with antral gastritis in children", N Engl J Med, 316, pp.1557~1561 (1984)
- Mitchell HM, "Helicobacter pylori infection in children: potential clues to pathogenesis", J Pediatr Gastrenterol Nutr, 16, pp.120~125 (1993)
- Gottrand F, "Normal gastric histology in Helicobacter pylori-infected children", J Pediatr Gastroenterol Nutr, 25, pp.74~78 (1997)
- Langenberg W, "Follow-up study of individuals with untreated Campylobacter pylori-associated gastritis and of noninfected persons with non-ulcer dyspepsia", J Infect Dis, 157, pp.1245~1249 (1988)
- 최연호, "소아 Helicobacter pylori 감염의 진단과 치료", Korean Journal of Pediatrics, 47(3), pp.235~239 (2004), 대한소아과학회
- Gold BD, "Helicobacter pylori infection in children: recommendations for diagnosis and treatment", J Pediatr Gastroenterol Nutr, 31, pp.490~497 (2000)
- Kim KM, "Histopathology and expression of Ki-67 and cyclooxygenase-2 in childhood Helicobacter pylori gastritis", J Gastroenterol, 39, pp.231~237 (2004)
- 성흥섭, "Helicobacter pylori 항균제 감수성 검사의 임상적 유용성", Annals of Laboratory Medicine, 26(3), pp.179~184 (2006), 대한진단검사의학회
- 성흥섭, "디스크확산법에 의한 Helicobacter pylori의 Clarithromycin과 Amoxicillin 항균제감수성 검사", 대한임상미생물학회지, 12(1), pp.30~36 (2009), 대한임상미생물학회
- Malfertheiner P, "Current concepts in the management of Helicobacter pylori infection-the Maastricht 2-2000 Consensus Report", Aliment Pharmacol Ther, 16, pp.167~180 (2002)
- 김재규, "Helicobacter pylori 감염 치료", 대한소화기학회지, 46(3), pp.172~180 (2005), 대한소화기학회
- 이정훈, "서울 동작, 관악 지역의 한 2차 의료기관에서 Helicobacter pylori 제균 성적", 대한내과학회지, 65(4), pp.422~425 (2003), 대한내과학회
- Murakami K, "Drug sensitivity test for Helicobacter pylori", Nippon Rinsho, 60(2), pp.350~353 (2002)
- Osato MS, "Antimicrobial susceptibility testing for Helicobacter pylori: sensitivity test results and their clinical relevance", Curr Pharm Des, 6, pp.1545~1545 (2000)
- Smaill F, "Antibiotic susceptibility and resistance testing: an overview", Can J Gastroenterol, 14, pp.871~875 (2000)
- Kato S, "Antibiotic resistance of Helicobacter pylori strains in Japanese children", J Clin Microbiol, 40, pp.649~653 (2002)
- Perfomance standards for antimicrobial susceptibility testing: informational supplement, "National Committee for Clinical Laboratory Standard", NCCLS, ~, pp.NCCLS document M100-S9 (1999)
- Kim ES, "Comparison of modified broth microdilution method, E test, and disk diffusion method for antimicrobial susceptibility testing of Helicobacter pylori", Korean J Clin Pathol, 18, pp.559~564 (1998)
- 강정옥, "실용적인 Helicobacter pylori 항균제감수성검사법의 확립을 위한 네 가지 검사법의 비교", 대한임상미생물학회지, 8(1), pp.82~89 (2005), 대한임상미생물학회
- Chung CH, "Analysis of metronidazole, clarithromycin and tetracycline resistance of Helicobacter pylori isolates from Korea", Korean J Helicobacter Res Prac, 2, pp.57~60 (2002)
- Lee H, "Impact of metronidazole resistance on eradication rate for Helicobacter pylori", Korean J Gastroenterol, 46, pp.142~145 (2005)
- 이혜경, "Multicenter Study for the Frequency of 23S rRNA Point Mutations Associated with Clarithromycin Resistance in Helicobacter pylori in Korea", 대한임상미생물학회지, 11(2), pp.84~89 (2008), 대한임상미생물학회
- 김정목, "한국인 환자에서 분리한 Helicobacter pylori 균주의 항생제 내성률", 대한소화기학회지, 47(5), pp.337~349 (2006), 대한소화기학회
- 정우철, "Helicobacter pylori 제균요법 적용의 실태 분석: 단일 기관 연구", 대한소화기학회지, 53(4), pp.221~227 (2009), 대한소화기학회
- Kim SJ, "Antimicrobial resistance rate of Helicobacter pylori isolates and detection of mechanism of clarithromycin resistance", Korean J Med, 61, pp.470~478 (2001)
- 방소영, "소화성 궤양 환자에서 Helicobacter pylori 항생제 내성률 변화", 대한소화기학회지, 50(6), pp.356~362 (2007), 대한소화기학회
- Agudo S, "High percentage of clarithromycin and metronidazole resistance in Helicobacter pylori clinical isolates obtained from Spanish children", Rev Esp Quimioter, 22, pp.88~92 (2009)
- Wewer V, "Helicobacter pylori infection in pediatrics", Helicobacter, 8(1), pp.61~67 (2003)