Antimicrobial resistance incidence risk and factors among Helicobacter pylori-infected persons, United States

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

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)1088-1094
Number of pages7
JournalEmerging infectious diseases
Issue number6
StatePublished - Jun 2004
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases


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