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目的 探讨儿童幽门螺杆菌(H.pylori)临床分离株毒力基因与抗生素耐药之间的关系.方法 从具有上消化道症状的90例患儿胃窦黏膜中分离培养H.pylori阳性菌株,采用E-test法和K-B法检测H.pylori对抗生素耐药性,聚合酶链反应(PCR)检测H.pylori cagA、vacA及iceA基因.结果 在胃窦黏膜分离培养的90株H.pylori菌株中,8株(8.9％)对克拉霉素耐药,31株(34.4％)对甲硝唑耐药,12株(13.3％)对克拉霉素和甲硝唑二重耐药,39株(43.3％)对抗生素均不耐药,未发现对阿莫西林和呋喃唑酮耐药的H.pylori菌株;cagA基因阳性检出率为93.3％(84/90),vacAs1a、vacAs1c、vacAm1和vacAm2基因阳性检出率分别为77.8％(70/90)、22.2％ (20/90)、32.2％(29/90)和67.8％(61/90),vacAs1a/m1、vacAs1a/m2、vacAs1c/m1和vacAs1c/m2基因阳性检出率分别为30.0％(27/90)、51.1％(46/90)、3.3％(3/90)和16.7％(15/90),iceA1和iceA2基因阳性检出率分别为87.7％(79/90)和7.8％(7/90).H.pylori毒力基因型在克拉霉素耐药组、甲硝唑耐药组、克拉霉素+甲硝唑二重耐药组和对抗生素敏感组四组间的阳性检出率比较,差异均无统计学意义(P＞0.05).结论 儿童H.pylori临床分离菌株毒力基因型与抗生素耐药无相关性.“,”Objective To explore the relationship between virulence genes and antibiotic resistance in Helicobacterpylori (H.pylori) isolates in children.Methods The stains of H.pylori were isolated from antral mucosa in 90 pediatric patients with upper gastrointestinal symptoms.E-test and K-B test were used to detect the antibiotic resistance ofH.pylori isolates.PCR was performed to detect the cagA,vacA and iceA genes of H.pylori.Results Among these 90 strains of H.pylori isolated from antral mucosa,there were 8 strains (8.9％) resistant to clarithromycin,31 strains (34.4％) resistant to metronidazole,12 trains (13.3％) resistant to clarithromycin and metronidazole,and 39 strains (43.3％) not resistant to antibiotics.There were no strains resistant to amoxicillin or furazolidone.The positive detection rate of cagA gene,vacAs1a,vacAs1c,vacAm1,and vacAm2 genes were 93.3％ (84/90),77.8％ (70/90),22.2％ (20/90),32.2％ (29/90),and 67.8％ (61/90),respectively.The positive detection rates of vacAs1a/m1,vacAs1a/m2,vacAs1c/m1,and vacAs1c/m2 genes were 30.0％ (27/90),51.1％ (46/90),3.3％ (3/90),and 16.7％ (15/90),respectively.The positive detection rates of iceA1 and iceA2 genes were 87.7％ (79/90) and 7.8％ (7/90),respectively.There was no difference in positive detection rate of H.pylori virulence genes among clarithromycin resistance group,metronidazole resistant group,clarithromycin and metronidazole double resistance group and antibiotics sensitive group (P ＞ 0.05).Conclusion There was no relationship between virulence gene and antibiotic resistance in H.pylori clinical isolates in children.