Antimicrobial resistance incidence and risk factors among Helicobacter pylori-infected persons, United States.
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.
Duck
William M
WM
Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. wdd8@cdc.gov
Sobel
Jeremy
J
Pruckler
Janet M
JM
Song
Qunsheng
Q
Swerdlow
David
D
Friedman
Cindy
C
Sulka
Alana
A
Swaminathan
Balasubra
B
Taylor
Tom
T
Hoekstra
Mike
M
Griffin
Patricia
P
Smoot
Duane
D
Peek
Rick
R
Metz
David C
DC
Bloom
Peter B
PB
Goldschmidt
Steven
S
Parsonnet
Julie
J
Triadafilopoulos
George
G
Perez-Perez
Guillermo I
GI
Vakil
Nimish
N
Ernst
Peter
P
Czinn
Steve
S
Dunne
Donald
D
Gold
Ben D
BD
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
D000900:Anti-Bacterial Agents