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 A...

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Bibliographic Details
Published in:	Emerging infectious diseases Vol. 10; no. 6; pp. 1088 - 1094
Main Authors:	Duck, William M, Sobel, Jeremy, Pruckler, Janet M, Song, Qunsheng, Swerdlow, David, Friedman, Cindy, Sulka, Alana, Swaminathan, Balasubra, Taylor, Tom, Hoekstra, Mike, Griffin, Patricia, Smoot, Duane, Peek, Rick, Metz, David C, Bloom, Peter B, Goldschmidt, Steven, Parsonnet, Julie, Triadafilopoulos, George, Perez-Perez, Guillermo I, Vakil, Nimish, Ernst, Peter, Czinn, Steve, Dunne, Donald, Gold, Ben D
Format:	Journal Article
Language:	English
Published:	United States U.S. National Center for Infectious Diseases 01-06-2004 Centers for Disease Control and Prevention
Subjects:	Adolescent Adult Aged Aged, 80 and over Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Anti-infective agents antimicrobial resistance Child Child, Preschool Drug Resistance, Multiple, Bacterial Female Helicobacter Infections - drug therapy Helicobacter Infections - epidemiology Helicobacter Infections - microbiology Helicobacter pylori Helicobacter pylori - drug effects Helicobacter pylori - isolation & purification Humans Incidence Logistic Models Longitudinal Studies Male Microbial Sensitivity Tests Middle Aged Multivariate Analysis Prospective Studies Risk Factors Stomach Diseases - drug therapy Stomach Diseases - epidemiology Stomach Diseases - microbiology United States United States - epidemiology United States USA
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Summary:	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.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	1080-6040 1080-6059
DOI:	10.3201/eid1006.030744