Emerging Infectious Diseases (Jun 2004)

Antimicrobial Resistance Incidence and Risk Factors among Helicobacter pylori–Infected Persons, United States

  • William M. Duck,
  • Jeremy Sobel,
  • Janet M. Pruckler,
  • Qunsheng Song,
  • David L. Swerdlow,
  • Cindy R. Friedman,
  • Alana Sulka,
  • Balasubra Swaminathan,
  • Tom Taylor,
  • Mike Hoekstra,
  • Patricia M. Griffin,
  • Duane Smoot,
  • Rick Peek,
  • DavidC. Metz,
  • Peter B. Bloom,
  • Steven Goldschmid,
  • Julie Parsonnet,
  • George Triadafilopoulos,
  • Guillermo I. Perez-Perez,
  • Nimish Vakil,
  • Peter Ernst,
  • Steve Czinn,
  • Donald Dunne,
  • Ben D. Gold

DOI
https://doi.org/10.3201/eid1006.030744
Journal volume & issue
Vol. 10, no. 6
pp. 1088 – 1094

Abstract

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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 prevalence 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 (4.8%) 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.

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