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Long-term persistence of resistant Enterococcus species after antibiotics to eradicate Helicobacter pylori

Article Abstract:

Background: Antibiotic treatment selects for resistance not only in the pathogen to which it is directed but also in the indigenous microflora. Objective: To determine whether a widely used regimen (clarithromycin, metronidazole, and omeprazole) for Helicobacter pylori eradication affects resistance development in enterococci. Design: Cohort study. Setting: Endoscopy units at 3 community hospitals in Sweden. Patients: 5 consecutive dyspeptic patients who were colonized with H. pylori, had endoscopy-confirmed duodenal ulcer, and received antibiotic treatment, and 5 consecutive controls with dyspepsia but no ulcer who did not receive treatment. Measurements: Fecal samples were obtained from patients and controls before, immediately after, 1 year after, and 3 years after treatment. From each patient and sample, enterococci were isolated and analyzed for DNA fingerprint, clarithromycin susceptibility, and presence of the erm(b) gene. Results: In treated patients, all enterococci isolated immediately after treatment showed high-level clarithromycin resistance due to erm(b). In 3 patients, resistant enterococci persisted for 1 to 3 years after treatment. No resistance developed among controls. Conclusion: A common H. pylori treatment selects for highly resistant enterococci that can persist for at least 3 years without further selection.

Author: Blaser, Martin J., Sjolund, Maria, Wreiber, Karin, Andersson, Dan I., Engstrand, Lars
Publisher: American College of Physicians
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 2003
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Past antibiotic use affects resistance and outcomes of Helicobacter pylori infection

Article Abstract:

Antibiotic use can cause bacteria in the body to become resistant to the antibiotic, according to a study of 125 patients. This means the antibiotic would not be able to kill the bacteria. In this study, the bacteria was Helicobacter pylori, which lives in the stomach and usually does not cause problems. But when it does, doctors may not be able to treat the infection if the bacteria is resistant to antibiotics.

Publisher: American College of Physicians
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 2003

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Effects of antibiotic treatment for Helicobacter pylori on normal bowel bacteria

Article Abstract:

Antibiotics that are taken to kill one particular type of bacteria can affect other bacteria in the body as well, according to a study of 10 patients. Five patients who took antibiotics to treat Helicobacter pylori infection were found to have other bacteria in their gastrointestinal tract that had become resistant to the antibiotics. This did not occur in the other five patients who did not take antibiotics.

Publisher: American College of Physicians
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 2003

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Subjects list: Causes of, Drug therapy, Drug resistance in microorganisms, Microbial drug resistance, Helicobacter infections, Enterococcus
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