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Volume 10, Number 6—June 2004
Research

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§§, and Ben D. Gold*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Howard University Medical Center, Washington, DC, USA; ‡Vanderbilt University Medical Center, Nashville, Tennessee, USA; §University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA; ¶Atlanta Veterans Affairs Medical Center, Atlanta, Georgia, USA; #Stanford University Medical Center, Palo Alto, California, USA; **New York University School of Medicine, New York, New York, USA; ††Sinai Samaritan Medical Center, Milwaukee, Wisconsin, USA; ‡‡University of Virginia, Charlottesville, Virginia, USA; §§University Hospitals of Cleveland, Cleveland, Ohio, USA; ¶¶Indiana University Medical Center, Indianapolis, Indiana, USA

Main Article

Table 4

Univariate analysis of risk factors for resistance to >1 antimicrobial agent among Helicobacter pylori isolates submitted to HARP, 1998–2002

Risk factor Proportion of patients harboring resistant H. pylori isolate
Odds ratio (95% CI)
Exposed, n (%) Unexposed, n (%)
Zantac use 12 mo before EGD
25 (48)
89 (32)
2.0 (1.1–3.6)b
Tums use 12 mo before EGD
19 (51)
95 (32)
2.2 (1.1–4.4)b
Tums use 30 d before EGD
12 (55)
102 (33)
2.4 (>1.0–5.8)b
Mylanta use 12 mo before EGD
4 (15)
110 (36)
0.3 (0.1–1.0)
Took antibiotic 12 mo before EGD
29 (43)
68 (34)
1.5 (0.9–2.6)
Past treatment of H. pylori infection with:



PPI
5 (71)
109 (34)
4.9 (1.0–26)
Clarithromycin
5 (83)
109 (33)
9.9 (1.1–86)
Treatment for H. pylori a second time in the past 5 years
11 (65)
107 (32)
3.8 (1.4–11)
Treatment of H. pylori infection more than once with



PPI
8 (80)
106 (33)
8.1 (1.7–39)
Clarithromycin
8 (80)
106 (33)
8.1 (1.7–39)
Age >57 years
50 (31)
68 (37)
0.8 (0.5–1.2)
Race/ethnicity



Black
67 (39)
51 (29)
1.6 (1.0–2.4)
Hispanic
2 (11)
116 (35)
0.2 (0.1–1.0)
Male sex
65 (31)
47 (42)
0.6 (0.4–1.0)
HARP site



New York, NY
3 (14)
115 (35)
0.3 (0.1–1.0)
Palo Alto, CA
4 (17)
114 (35)
0.4 (0.1–1.1)
Atlanta, GA
8 (22)
110 (36)
0.5 (0.2–1.1)
Nashville, TN 11 (24) 107 (35) 0.6 (0.3–1.2)

aN = 347; HARP, Helicobacter pylori Antimicrobial Resistance Monitoring Project; EGD, esophagogastro-duodenal endoscopy; PPI, proton pump inhibitor; CI, confidence interval.
bThese risk factors were not considered for multivariate analysis because of small cell-size differences between subjects with a resistant H. pylori infection and those without.

Main Article

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Page updated: February 22, 2011
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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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