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[仇军文,胡家露,吴开春,彭道荣,施炳龙,季万胜,樊代明.世界华人消化杂志,2001;9(7):739-742]rn目的研究幽门螺杆菌(H.pylori)cagA vacA基因亚型及其与抗生素耐药的关系.方法用琼脂稀释法测定50例H.pylori 临床分离株对克拉霉素,阿莫西林,替硝唑,甲硝唑的最低抑菌浓度(MIC),并计算MIC50和MIC90值.用多重PCR鉴定H.pylori菌株的vacA(sla,slb,s2,ml,m2)及cagA的型别.结果克拉霉素,阿莫西林,替硝唑,甲硝唑对H.pylori的MIC52和MIC90分别为:＜0.01 6 mg@L-1,0.016 mg@L1;0.016 mg@L-1,0.047 mg@L-1;16.000 mg@L-1,52.000 mg@L :25.140 mg@L -1 ,76.800 [email protected]菌株对克拉霉素,阿莫西林,替硝唑,甲硝唑的耐药率分别为0%,0%,20%和38%.在对替硝唑敏感的H.pylori菌株中,vacA sla,slb和s2型分别占50.0%,42.5%和7.5%;vacA ml和m2型占60.0%和40.0%;vacA sla/ml,slb/ml,sla/m2,slb/m2和s2/m2型分别占32.5%,27.5%,17.5%,15.0%和12.5%;cagA-和cagA型为87.5%和12.5%.在对替硝唑敏感的H.pylori菌株中,vacA sla,slb和s2型分别占50.0%,40.0%和10.0:vaccAml和m2型占40.0%和60.0%;vacA sla/ml,slb/ml,sla/m2,slb/m2和s2/m2型分别占20.0%.,20.0%,30.0%.20.0%和10.0%;cagA+和cagA-型为80.0%和20.0%.结论 H.pylori菌株对甲硝唑的耐药率明显高于H.pylori 对克拉霉素,阿莫西林,替硝唑的耐药率,不同cagA vacA基因亚型的H.pylori菌株对替硝唑的耐药率无显著差异. (潘伯荣)rn