Kháng kháng sinh của Helicobacter pylori và một số yếu tố liên quan ở trẻ em loét dạ dày tá tràng

Abstract

This study aimed to evaluate the antibiotic resistance of Helicobacter pylori (H. pylori) and its related factors in children with peptic ulcers, providing a foundation for treatment guidelines. A cross-sectional study was conducted on 176 patients with peptic ulcers who underwent H. pylori culturing and antibiotic susceptibility testing using the E-test method from October 2022 to May 2024. The resistance rates to amoxicillin, clarithromycin, metronidazole, levofloxacin, and tetracycline were 79.0%, 94.3%, 4.0%, 18.2%, and 1.1%, respectively. Dual resistance to amoxicillin and clarithromycin was identified in 61.9% of cases. Notably, 90.3% of H. pylori strains exhibited high-level resistance to clarithromycin (MIC > 8 µg/ml), while 72.7% demonstrated low-level resistance to amoxicillin (0.125 < MIC ≤ 2 µg/ml). Age was associated with amoxicillin resistance, while no correlation was found between gender, geographic location, medical history, or prior antibiotic use and antibiotic resistance. The findings suggest that high-dose amoxicillin combined with metronidazole is the preferred regimen for children under 8 years old, whereas a bismuth quadruple therapy is appropriate for eradicating H. pylori in children over 8 years old.