Nghiên cứu đột biến kháng levofloxacin của vi khuẩn Helicobacter pylori ở trẻ em viêm, loét dạ dày - tá tràng tại Bệnh viện Nhi đồng Cần Thơ năm 2021-2023=Study on levofloxacin resistance mutations of helicobacter pylori bacteria in children with gastritis and peptic ulcer at Can Tho children's hospital in 2021-2023

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Tác giả: Thị Thúy Loan Lê, Hồng Phong Nguyễn, Phan Hải Sâm Nguyễn, Trung Kiên Nguyễn, Huy Thanh Ông, Đỗ Hùng Trần, Đức Long Trần, Nhật Ngân Tuyền Võ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y dược học Cần Thơ, 2024

Mô tả vật lý: tr.153-160

Bộ sưu tập: Metadata

ID: 245153

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Levofloxacin được xem là một kháng sinh cứu vãn trong điều trị tiệt trừ Helicobacter pylori ở trẻ em. Tuy nhiên, đề kháng levofloxacin đang gia tăng và thay đổi giữa các khu vực trên thế giới. Tình trạng này liên quan đến các đột biến ở vùng xác định kháng quinolone của gen GyrA. Mục tiêu nghiên cứu: Xác định tỷ lệ các đột biến trên gen GyrA của vi khuẩn H. pylori ở trẻ 6-16 tuổi viêm, loét dạ dày tá tràng và một số yếu tố liên quan. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang trên 55 bệnh nhi tuổi từ 6-16 viêm, loét dạ dày tá tràng có nhiễm H. pylori tại Bệnh viện Nhi đồng Cần Thơ, giải trình tự gen để xác định các đột biến kháng levofloxacin. Kết quả: Ở bệnh nhi nhiễm H. pylori, tỷ lệ đột biến trên gen GyrA là 54,5%. Có hai vị rí phổ biến là amino acid 87 và 91, tỷ lệ đột biến đề kháng kháng sinh levofloxacin đối với các vị trí N87K, D91G, D91Y, D91N, lần lượt là 38,2%, 7,3%, 1,8%, 1,8%. Đặc biệt có 3 đột biến mới được phát hiện có khả năng gây kháng levofloxacin là A88V, K133N và A134P với cùng tỷ lệ (1,8%). Không có mối liên quan ý nghĩa thống kê giữ đột biến gen kháng Levofloxacin với giới tính, hình ảnh nội soi và tiền sử điều trị H. Pylori. Kết luận: Nghiên cứu đã xác định được tỷ lệ các đột biến kháng thuốc và các dạng đột biến đề kháng kháng sinh levofloxacin của vi khuẩn H. pylori. Ngoài ra, nghiên cứu còn cho thấy rằng đột biến trên gen GyrA không liên quan đến kiểu hình đề kháng levofloxacin.Levofloxacin is considered a rescue antibiotic in the treatment H.pylori due to a high resistance to clarithromycin and the restriction of tetracycline use only in older children. However, the resistance to levofloxacin is currently increasing, varying between regions worldwide, and the resistance situation is associated with mutations in the specific areas of the quinolone resistance gene GyrA. Objectives: To determine the rate of GyrA gene mutations resistant to levofloxacin of H. pylori bacteria in children 6-16 years old with peptic ulcers and some related factors. Materials and methods: A cross-sectional descriptive study was conducted on 55 pediatric patients aged 6-16 with H.pylori-positive gastroduodenitis at Can Tho Children's Hospital from January 2021 to January 2023. Results: In pediatric patients infected with H. pylori, the mutation rate of the GyrA gene is 54.5%. The two most common variants are amino acid positions 87 and 91, with mutation rates conferring resistance to levofloxacin at N87K, D91G, D91Y, and D91N being 38.2%, 7.3%, 1.8%, and 1.8%, respectively. Particularly noteworthy are three newly discovered mutations with potential levofloxacin resistance: A88V, K133N, and A134P, each with an equal rate of 1.8% Conclusion: The study has determined the rate of drug resistance mutations and levofloxacin antibiotic resistance mutations in H. pylori bacteria. In addition, the study also showed that mutations in the GyrA gene were not related to the levofloxacin resistance phenotype.

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