{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T23:08:52Z","timestamp":1770505732633,"version":"3.49.0"},"reference-count":33,"publisher":"Microbiology Society","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,1,1]]},"abstract":"<jats:p>The aim of this study was to assess the clinical and socio-demographic risk factors for primary<jats:italic>Helicobacter pylori<\/jats:italic>antibacterial resistance. In total, 266 consecutive<jats:italic>H. pylori<\/jats:italic>strains, from untreated symptomatic adult patients who answered a questionnaire, were evaluated. Strain susceptibility to amoxicillin, metronidazole, clarithromycin and tetracycline was tested by a breakpoint susceptibility test. Metronidazole resistance was found in fewer (17.0\u200a%) peptic ulcer patients than in non-ulcer subjects (28.3\u200a%,<jats:italic>P<\/jats:italic>=0.037), as well as in fewer patients born in villages (12.7\u200a%) than in those born in towns (27.6\u200a%,<jats:italic>P<\/jats:italic>=0.016). Clarithromycin resistance varied from 8.8 to 23.4\u200a% (<jats:italic>P<\/jats:italic>=0.009) within the hospital centres. The highest clarithromycin resistance rate was found in hospital centre A (23.4\u200a%) compared to other centres (12.9\u200a%,<jats:italic>P<\/jats:italic>=0.041). The factors sex, age, symptom duration, non-steroidal anti-inflammatory drug use, diabetes, type of profession and educational level were not associated with<jats:italic>H. pylori<\/jats:italic>resistance. Logistic regression revealed that the risk factors for metronidazole resistance were non-ulcer disease [odds ratio (OR) 1.95, 95 % confidence interval (95\u200a% CI) 1.04\u20133.65] and a birthplace of a town (OR 2.64, 95\u200a% CI 1.18\u20135.93). The hospital centre may be a risk factor (OR 2.07, 95\u200a% CI 1.02\u20134.21) for clarithromycin resistance but further studies are required to verify this suggestion. In conclusion, the knowledge of the risk factors for<jats:italic>H. pylori<\/jats:italic>resistance to antibacterials could facilitate the treatment choice for<jats:italic>H. pylori<\/jats:italic>eradication.<\/jats:p>","DOI":"10.1099\/jmm.0.003855-0","type":"journal-article","created":{"date-parts":[[2008,12,12]],"date-time":"2008-12-12T19:33:05Z","timestamp":1229110385000},"page":"94-100","source":"Crossref","is-referenced-by-count":12,"title":["Evaluation of clinical and socio-demographic risk factors for antibacterial resistance of Helicobacter pylori in Bulgaria"],"prefix":"10.1099","volume":"58","author":[{"given":"Lyudmila","family":"Boyanova","sequence":"first","affiliation":[{"name":"Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliana","family":"Ilieva","sequence":"additional","affiliation":[{"name":"University Department of Social Medicine and Healthcare Management, Medical University of Sofia, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Galina","family":"Gergova","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoya","family":"Spassova","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital St Ivan Rilski, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rossen","family":"Nikolov","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital St Ivan Rilski, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lubomir","family":"Davidkov","sequence":"additional","affiliation":[{"name":"Departments of Gastroenterology and General Surgery, University Hospital St Ekaterina, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivailo","family":"Evstatiev","sequence":"additional","affiliation":[{"name":"Departments of Gastroenterology and General Surgery, University Hospital St Ekaterina, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Kamburov","sequence":"additional","affiliation":[{"name":"Urgent Endoscopy Unit, Emergency Hospital Pirogov, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolai","family":"Katsarov","sequence":"additional","affiliation":[{"name":"Second Surgery Department, University Alexander Hospital, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Mitov","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1111\/j.1469-0691.2007.01770.x","article-title":"Detection of Helicobacter pylori infection in symptomatic Bulgarian adults","volume":"13","author":"Boyanova","year":"2007","journal-title":"Clin Microbiol Infect"},{"key":"R2","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.diagmicrobio.2007.11.008","article-title":"Prevalence and evolution of Helicobacter pylori resistance to 6 antibacterial agents over 12\u2005years and correlation between susceptibility testing methods","volume":"60","author":"Boyanova","year":"2008","journal-title":"Diagn Microbiol Infect Dis"},{"key":"R3","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1046\/j.1365-2036.2003.01396.x","article-title":"Risk factors for failure of Helicobacter pylori therapy-results of an individual data analysis of 2751 patients","volume":"17","author":"Broutet","year":"2003","journal-title":"Aliment Pharmacol Ther"},{"key":"R4","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1556\/oh.2007.28013","article-title":"The epidemiology of clarithromycin resistance of Helicobacter pylori infection in Hungary","volume":"148","author":"Buz\u00e1s","year":"2007","journal-title":"Orv Hetil"},{"key":"R5","doi-asserted-by":"crossref","first-page":"E3","DOI":"10.2807\/esm.12.07.00721-en","article-title":"Surveillance of primary antibiotic resistance of Helicobacter pylori at centres in England and Wales over a six-year period (2000\u20132005","volume":"12","author":"Chisholm","year":"2007","journal-title":"Euro Surveill"},{"key":"R6","article-title":"Performance Standards for Antimicrobial Susceptibility Testing , tenth informational supplement, approved standard M100\u2013S10, M7","year":"2000"},{"key":"R7","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.3201\/eid1006.030744","article-title":"Antimicrobial resistance incidence and risk factors among Helicobacter pylori -infected persons, United States","volume":"10","author":"Duck","year":"2004","journal-title":"Emerg Infect Dis"},{"key":"R8","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1093\/jac\/dkh343","article-title":"Helicobacter pylori antibiotic resistance patterns and genotypes in adult dyspeptic patients from a regional population in North Wales","volume":"54","author":"Elviss","year":"2004","journal-title":"J Antimicrob Chemother"},{"key":"R9","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1099\/jmm.0.45896-0","article-title":"Helicobacter pylori antibiotic-resistance patterns and risk factors in adult dyspeptic patients from ethnically diverse populations in central and south London during 2000","volume":"54","author":"Elviss","year":"2005","journal-title":"J Med Microbiol"},{"key":"R10","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0924-8579(00)00205-3","article-title":"Factors affecting the variation in antibiotic resistance of Helicobacter pylori over a 3-year period","volume":"16","author":"Ferrero","year":"2000","journal-title":"Int J Antimicrob Agents"},{"key":"R11","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1097\/00042737-200111000-00007","article-title":"Helicobacter pylori eradication therapy is more effective in peptic ulcer than in non-ulcer dyspepsia","volume":"13","author":"Gisbert","year":"2001","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"R12","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1111\/j.1523-5378.2006.00396.x","article-title":"High rate of Helicobacter pylori reinfection in children and adolescents","volume":"11","author":"Halitim","year":"2006","journal-title":"Helicobacter"},{"key":"R13","doi-asserted-by":"crossref","first-page":"2726","DOI":"10.3748\/wjg.v11.i18.2726","article-title":"Do patients with non-ulcer dyspepsia respond differently to Helicobacter pylori eradication treatments from those with peptic ulcer disease? A systematic review","volume":"11","author":"Huang","year":"2005","journal-title":"World J Gastroenterol"},{"key":"R14","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1111\/j.1445-5994.1998.tb00660.x","article-title":"Prevalence and demographic determinants of metronidazole resistance by Helicobacter pylori in a large cosmopolitan cohort of Australian dyspeptic patients","volume":"28","author":"Katelaris","year":"1998","journal-title":"Aust N Z J Med"},{"key":"R15","doi-asserted-by":"crossref","first-page":"2214","DOI":"10.1128\/AAC.44.8.2214-2216.2000","article-title":"Regional differences in metronidazole resistance and increasing clarithromycin resistance among Helicobacter pylori isolates from Japan","volume":"44","author":"Kato","year":"2000","journal-title":"Antimicrob Agents Chemother"},{"key":"R16","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1046\/j.1365-2036.2003.01406.x","article-title":"Effect of different proton pump inhibitors, differences in CYP2C19 genotype and antibiotic resistance on the eradication rate of Helicobacter pylori infection by a 1-week regimen of proton pump inhibitor, amoxicillin and clarithromycin","volume":"17","author":"Kawabata","year":"2003","journal-title":"Aliment Pharmacol Ther"},{"key":"R17","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1111\/j.1365-2036.2004.01930.x","article-title":"Primary Helicobacter pylori resistance to metronidazole and clarithromycin in the Finnish population","volume":"19","author":"Koivisto","year":"2004","journal-title":"Aliment Pharmacol Ther"},{"key":"R18","doi-asserted-by":"crossref","first-page":"5011","DOI":"10.1128\/JCM.41.11.5011-5014.2003","article-title":"Metronidazole-resistant Helicobacter pylori is more prevalent in patients with nonulcer dyspepsia than in peptic ulcer patients in a multiethnic Asian population","volume":"41","author":"Lui","year":"2003","journal-title":"J Clin Microbiol"},{"key":"R19","doi-asserted-by":"crossref","first-page":"463","DOI":"10.7326\/0003-4819-139-6-200309160-00008","article-title":"The relationship among previous antimicrobial use, antimicrobial resistance, and treatment outcomes for Helicobacter pylori infections","volume":"139","author":"McMahon","year":"2003","journal-title":"Ann Intern Med"},{"key":"R20","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1136\/gut.2003.022111","article-title":"H. pylori antibiotic resistance: prevalence, importance, and advances in testing","volume":"53","author":"Megraud","year":"2004","journal-title":"Gut"},{"key":"R21","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1128\/CMR.00033-06","article-title":"Helicobacter pylor i detection and antimicrobial susceptibility testing","volume":"20","author":"Megraud","year":"2007","journal-title":"Clin Microbiol Rev"},{"key":"R22","doi-asserted-by":"crossref","first-page":"2747","DOI":"10.1128\/AAC.43.11.2747","article-title":"Antimicrobial susceptibility testing of Helicobacter pylori in a large multicenter trial: the MACH 2 study","volume":"43","author":"Megraud","year":"1999","journal-title":"Antimicrob Agents Chemother"},{"key":"R23","doi-asserted-by":"crossref","first-page":"13","DOI":"10.7326\/0003-4819-136-1-200201010-00008","article-title":"Risk factors for Helicobacter pylori resistance in the United States: the surveillance of H. pylori antimicrobial resistance partnership (SHARP) study, 1993\u20131999","volume":"136","author":"Meyer","year":"2002","journal-title":"Ann Intern Med"},{"key":"R24","doi-asserted-by":"crossref","first-page":"343","DOI":"10.2174\/157339905774574275","article-title":"The role of H. pylori infection in diabetes","volume":"1","author":"Ojetti","year":"2005","journal-title":"Curr Diabetes Rev"},{"key":"R25","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1001\/archinte.161.9.1217","article-title":"Pattern of primary resistance of Helicobacter pylori to metronidazole or clarithromycin in the United States","volume":"161","author":"Osato","year":"2001","journal-title":"Arch Intern Med"},{"key":"R26","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1046\/j.1365-2036.2001.01068.x","article-title":"Helicobacter pylori antimicrobial resistance in the United Kingdom: the effect of age, sex and socio-economic status","volume":"15","author":"Parsons","year":"2001","journal-title":"Aliment Pharmacol Ther"},{"key":"R27","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/S1590-8658(00)80352-7","article-title":"Prevalence of Helicobacter pylori resistance to antibiotics in Northeast Italy: a multicentre study","volume":"32","author":"Pilotto","year":"2000","journal-title":"Dig Liver Dis"},{"key":"R28","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.3748\/wjg.v9.i5.1126","article-title":"Type 2 diabetes mellitus affects eradication rate of Helicobacter pylori","volume":"9","author":"Sarg\u00fdn","year":"2003","journal-title":"World J Gastroenterol"},{"key":"R29","doi-asserted-by":"crossref","first-page":"931","DOI":"10.7326\/0003-4819-140-11-200406010-00018","article-title":"Risk factors for Helicobacter pylori resistance","volume":"140","author":"Seow","year":"2004","journal-title":"Ann Intern Med"},{"key":"R30","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1046\/j.1440-1746.2003.03174.x","article-title":"Geographical difference in antimicrobial resistance pattern of Helicobacter pylori clinical isolates from Indian patients: multicentric study","volume":"18","author":"Thyagarajan","year":"2003","journal-title":"J Gastroenterol Hepatol"},{"key":"R31","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/S1590-8658(03)00265-2","article-title":"Primary and secondary antibiotic resistance of Helicobacter pylori strains isolated in central Italy during the years 1998\u20132002","volume":"35","author":"Toracchio","year":"2003","journal-title":"Dig Liver Dis"},{"key":"R32","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1136\/gut.46.3.321","article-title":"Importance of Helicobacter pylori cagA and vacA status for the efficacy of antibiotic treatment","volume":"46","author":"Van Doorn","year":"2000","journal-title":"Gut"},{"key":"R33","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1136\/gut.52.4.490","article-title":"Aspirin inhibits the growth of Helicobacter pylori and enhances its susceptibility to antimicrobial agents","volume":"52","author":"Wang","year":"2003","journal-title":"Gut"}],"container-title":["Journal of Medical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.microbiologyresearch.org\/content\/journal\/jmm\/10.1099\/jmm.0.003855-0?crawler=true","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T17:42:59Z","timestamp":1632764579000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.microbiologyresearch.org\/content\/journal\/jmm\/10.1099\/jmm.0.003855-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,1,1]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2009,1,1]]}},"URL":"https:\/\/doi.org\/10.1099\/jmm.0.003855-0","relation":{},"ISSN":["0022-2615","1473-5644"],"issn-type":[{"value":"0022-2615","type":"print"},{"value":"1473-5644","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,1,1]]}}}