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Antimicrobial Resistance Patterns and Predictors in Helicobacter pylori Infection: A Real-World Cohort Study
Sergiu Dorin Matei1,2, Ramona Nicoleta Suciu3, Tiberia Ilias2
1Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania.
High antimicrobial resistance, especially to clarithromycin, impacts Helicobacter pylori eradication. Prior treatment is the key predictor of resistance, necessitating tailored, stewardship-focused strategies for H. pylori infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Rising antimicrobial resistance (AMR) compromises empirical eradication of Helicobacter pylori (H. pylori).
- Clarithromycin-containing regimens are increasingly ineffective due to H. pylori resistance.
- Local resistance data and clinical predictors are crucial for effective H. pylori treatment.
Purpose of the Study:
- To evaluate antimicrobial resistance patterns in H. pylori.
- To identify clinical determinants associated with H. pylori resistance.
- To inform empirical H. pylori eradication strategies in a tertiary-care setting.
Main Methods:
- Retrospective observational study of 352 adult patients with H. pylori infection.
- Culture and antibiotic susceptibility testing for 168 patients.
- Multivariable logistic regression to identify predictors of H. pylori resistance.
Main Results:
- 44.6% of patients exhibited resistance to at least one antimicrobial.
- High clarithromycin (42.5%) and metronidazole (36.4%) resistance rates were observed.
- Prior eradication therapy was independently associated with H. pylori resistance (aOR 2.41).
Conclusions:
- Clarithromycin resistance in H. pylori significantly exceeds thresholds for empirical therapy.
- Previous H. pylori eradication attempts are the primary predictor of current resistance.
- Resistance-informed, stewardship-oriented management is essential for H. pylori infections.
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