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Long-term persisten...
Long-term persistence of resistant Enterococcus species after antibiotics to eradicate Helicobacter pylori
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- Sjölund, Maria (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Klinisk bakteriologi
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Wreiber, Karin (författare)
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- Andersson, Dan I (författare)
- Uppsala universitet,Institutionen för folkhälso- och vårdvetenskap
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Blaser, Martin J (författare)
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- Engstrand, Lars (författare)
- Karolinska Institutet,Uppsala universitet,Institutionen för medicinska vetenskaper
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(creator_code:org_t)
- American College of Physicians, 2003
- 2003
- Engelska.
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Ingår i: Annals of Internal Medicine. - : American College of Physicians. - 0003-4819 .- 1539-3704. ; 139:6, s. 483-7
- Relaterad länk:
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http://www.ncbi.nlm....
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https://urn.kb.se/re...
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http://kipublication...
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https://doi.org/10.7...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- 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.
Nyckelord
- Aged; Aged
- 80 and over
- Anti-Bacterial Agents/*therapeutic use
- Anti-Ulcer Agents/therapeutic use
- Clarithromycin/therapeutic use
- Drug Resistance; Bacterial
- Drug Therapy; Combination
- Duodenal Ulcer/drug therapy/microbiology
- Enterococcus/*drug effects
- Female
- Helicobacter Infections/*drug therapy/microbiology
- Helicobacter pylori
- Humans
- Male
- Metronidazole/therapeutic use
- Middle Aged
- Omeprazole/therapeutic use
- Prospective Studies
- Research Support; Non-U.S. Gov't
- Research Support; U.S. Gov't; P.H.S.
Publikations- och innehållstyp
- vet (ämneskategori)
- art (ämneskategori)
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