Helicobacter pylori antimicrobial resistance in the United Kingdom: the effect of age, sex and socio-economic status.
BACKGROUND
Helicobacter pylori antimicrobial resistance is the most common reason for eradication failure. Small studies have shown metronidazole resistance to be more prevalent in certain population groups.


OBJECTIVE
To determine the resistance rates in a large cohort of patients from a single centre in the UK, and to evaluate resistance patterns over time, according to age, sex and socio-economic status.


METHODS
Consecutive patients with H. pylori-positive antral gastric biopsy samples were studied from 1994 to 1999. Susceptibility testing was performed to metronidazole, tetracycline, macrolide and amoxicillin by the modified disk diffusion


METHODS
The Jarman under-privileged area score was used as a measure of socio-economic status.


RESULTS
A total of 1064 patients were studied. Overall metronidazole resistance was 40.3%, decreasing with age (P < 0.0001, odds ratio for patients over 60 years 0.63, 95% CI: 0.48-0.80). Women were more likely to have metronidazole resistant strains (P=0.003, odds ratio 1.5, 95% CI: 1.15-1.91), but there was no association with Jarman score. Macrolide resistance was associated with metronidazole resistance (P=0.03, odds ratio 2.14, 95% CI: 1.07-4.28).


CONCLUSIONS
Metronidazole resistance in H. pylori is highly prevalent and more common in women and the young, but does not appear to be related to socio-economic status.
Parsons
H K
HK
Gastroenterology and Liver Unit, Royal Hallamshire Hospital, Sheffield, UK.
Carter
M J
MJ
Sanders
D S
DS
Winstanley
T
T
Lobo
A J
AJ
D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D003953:Diagnosis-Related Groups; D004352:Drug Resistance, Microbial; D005260:Female; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000494:pharmacology*; D008875:Middle Aged; D011159:Population Surveillance; D017678:Sex Distribution; D012923:Social Class; D006113:United Kingdom
D008795:Metronidazole