title: Antimicrobial resistance incidence and risk factors among Helicobacter pylori-infected persons, United States.
abstract: Helicobacter pylori is the primary cause of peptic ulcer disease and an etiologic agent in the development of gastric cancer. H. pylori infection is curable with regimens of multiple antimicrobial agents, and antimicrobial resistance is a leading cause of treatment failure. The Helicobacter pylori Antimicrobial Resistance Monitoring Program (HARP) is a prospective, multicenter U.S. network that tracks national incidence rates of H. pylori antimicrobial resistance. Of 347 clinical H. pylori isolates collected from December 1998 through 2002, 101 (29.1%) were resistant to one antimicrobial agent, and 17 (5%) were resistant to two or more antimicrobial agents. Eighty-seven (25.1%) isolates were resistant to metronidazole, 45 (12.9%) to clarithromycin, and 3 (0.9%) to amoxicillin. On multivariate analysis, black race was the only significant risk factor (p < 0.01, hazard ratio 2.04) for infection with a resistant H. pylori strain. Formulating pretreatment screening strategies or providing alternative therapeutic regimens for high-risk populations may be important for future clinical practice.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. wdd8@cdc.gov
authors.forename: William M
authors.initials: WM
authors.lastname: Duck
authors.forename: Jeremy
authors.initials: J
authors.lastname: Sobel
authors.forename: Janet M
authors.initials: JM
authors.lastname: Pruckler
authors.forename: Qunsheng
authors.initials: Q
authors.lastname: Song
authors.forename: David
authors.initials: D
authors.lastname: Swerdlow
authors.forename: Cindy
authors.initials: C
authors.lastname: Friedman
authors.forename: Alana
authors.initials: A
authors.lastname: Sulka
authors.forename: Balasubra
authors.initials: B
authors.lastname: Swaminathan
authors.forename: Tom
authors.initials: T
authors.lastname: Taylor
authors.forename: Mike
authors.initials: M
authors.lastname: Hoekstra
authors.forename: Patricia
authors.initials: P
authors.lastname: Griffin
authors.forename: Duane
authors.initials: D
authors.lastname: Smoot
authors.forename: Rick
authors.initials: R
authors.lastname: Peek
authors.forename: David C
authors.initials: DC
authors.lastname: Metz
authors.forename: Peter B
authors.initials: PB
authors.lastname: Bloom
authors.forename: Steven
authors.initials: S
authors.lastname: Goldschmidt
authors.forename: Julie
authors.initials: J
authors.lastname: Parsonnet
authors.forename: George
authors.initials: G
authors.lastname: Triadafilopoulos
authors.forename: Guillermo I
authors.initials: GI
authors.lastname: Perez-Perez
authors.forename: Nimish
authors.initials: N
authors.lastname: Vakil
authors.forename: Peter
authors.initials: P
authors.lastname: Ernst
authors.forename: Steve
authors.initials: S
authors.lastname: Czinn
authors.forename: Donald
authors.initials: D
authors.lastname: Dunne
authors.forename: Ben D
authors.initials: BD
authors.lastname: Gold
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D013272:Stomach Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents