| Abstract | Cilj:
Praćenje primarne antibiotske rezistencije sojeva na levofloksacin kako bismo utvrdili
njegovu učinkovitost u svrhu eradikacijske terapije infekcije s H. pylori, te utvrditi trendove
primarne antibiotske rezistencije na najčešće korištene antibiotike (amoksicilin, klaritromicin,
tetraciklin, metronidazol i levofloksacin).
Materijal i metode:
Istraživanje je provedeno na ukupno 1 172 bolesnika s dokazanom infekcijom s H. pylori, u
razdoblju od 1. siječnja 2009. do 31. prosinca 2013. godine u KBC-u Split.
U postupku statističke obrade izračunavali smo postotak rezistencije na svaki antibiotik
tijekom 5 godina, te iz njega izračunavali prosječan postotak rezistencije za svaki antibiotik
posebno, te prosječno odstupanje postotka rezistencije godišnje. Zatim smo proveli testiranje
hipoteze o razlici stopa rezistencije testom razlike između proporcija nezavisnih osnovnih
skupa; za to je bilo prikladno koristiti neparametarski hi-kvadrat test (χ² test). Promatrali smo
jednadžbe linearnog trenda za tri vrste antibiotika (klaritromicin, metronidazol i
levofloksacin). Na kraju smo podatke obrađivali Z-testom razlika između dviju proporcija.
Rezultati:
Rezultati ovog istraživanja ukazuju da postoji statistički značajna razlika (p < 0,05%) u
stopama primarne rezistencije na klaritromicin, metronidazol i levofloksacin, dok nema
rezistencije na amoksicilin i tetraciklin. Također smo ovim istraživanjem dobili da je stopa
rezistencije na klaritromicin iznad prosjeka, a na metronidazol i levofloksacin ispod prosjeka.
Razlika između prosječnih stopa rezistencije među antibioticima je statistički značajna (p <
0,05), a statistički je značajna i razlika u stopi rezistencije prema vrsti antibiotika u svakoj
promatranoj godini (p < 0,05).
Zaključak:
Zaključujemo da postoji značajan porast primarne rezistencije kod dvije vrste antibiotika,
klaritromicina i levofloksacina (p < 0,05), dok kod antibiotika metronidazola nema značajnog
porasta rezistencije (p > 0,05). Rezultati ovog istraživanja nesumnjivo ukazuju da je praćenje
primarne antibiotske rezistencije sojeva H. pylori na antibiotike (amoksicilin, klaritromicin,
tetraciklin, metronidazol i levofloksacin) nužno u svrhu utvrđivanja racionalne i učinkovite
eradikacijske terapije. |
| Abstract (english) | Objectives:
Monitoring of primary antibiotic resistance on levofloxacin in order to determine its
effectiveness in eradication therapy of H. pylori infection, and to identify trends in the
primary antibiotic resistance to commonly used antibiotics (amoxicillin, clarithromycin,
tetracycline, metronidazole and levofloxacin).
Material and Methods:
The study was conducted on a total of 1172 patients with proven infection with H. pylori, in
the period from 1 January 2009 until 31 December 2013 year in the Clinical Hospital
Center in Split.
In the process of statistical analysis, we calculated the percentage of resistance to each
antibiotic for 5 years, and from it we calculated the average percentage of resistance to every
antibiotic in particular, and the average deviation of the annual percentage resistance. Then
we spent testing hypotheses about the difference between the rate of resistance test differences
between the proportion of independent basic set; for it was appropriate to use nonparametric
chi-square test (χ² test). We observed a linear trend equation for the three types of antibiotics
(clarithromycin, metronidazole and levofloxacin). At the end of the data are still processed Z-test the difference between two proportions.
Results:
The results of this study have shown that there is a statistically significant difference (p <
0.05) in the rate of primary resistance to clarithromycin, metronidazole and levofloxacin,
while there is no resistance to amoxicillin and tetracycline. In this study, the rate of resistance
to clarithromycin is above average, and metronidazole and levofloxacin below average. The
difference between the average rate of antibiotic resistance among themselves was statistically
significant (p < 0.05), and there is also a statistically significant difference in the rate of
resistance to antibiotics in each of the observed years. In the end we conclude that there is a
significant increase in the primary resistance to two types of antibiotics, clarithromycin and levofloxacin (p < 0.05), while the resistance to antibiotic metronidazole is not significant (p >
0.05). Results of this research have certainly shown that monitoring of the primary antibiotic
resistance of H. pylori to antibiotics (amoxicillin, clarithromycin, tetracycline, metronidazole
and levofloxacin) is necessary for establishing the rational and efficient eradication therapy. |
