{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T03:56:15Z","timestamp":1777780575326,"version":"3.51.4"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,22]],"date-time":"2019-11-22T00:00:00Z","timestamp":1574380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012021","name":"Iran University of Medical Sciences","doi-asserted-by":"publisher","award":["24745\u201030\u201002\u201093"],"award-info":[{"award-number":["24745\u201030\u201002\u201093"]}],"id":[{"id":"10.13039\/100012021","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["APMIS"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>Eradication failure of <jats:italic>Helicobacter pylori<\/jats:italic> infection could play a causal role in progression of gastric disorders. In this study, infection with <jats:italic>H.\u00a0pylori<\/jats:italic> was followed in gastric biopsies of symptomatic adult patients at two phases during 1\u2010year period. Analyses were done to show association of therapeutic regimens with the refractory infection, changes in sequence types (STs) and minimum inhibitory concentration (MIC) values, and progression of histopathological changes. Infection with <jats:italic>H.\u00a0pylori<\/jats:italic> was confirmed in 32.3% (57\/170) of the patients. Persistent infection with <jats:italic>H.\u00a0pylori<\/jats:italic> was confirmed in 14 out of the 25 patients (56%) who participated at the second phase of the study. A difference between primary and secondary resistance rates to clarithromycin (49% vs 64.3%), metronidazole (76.36% vs 100%), and ciprofloxacin (45% vs 57.1%) was detected. Although the re\u2010emerged strains in patients with refractory infection did not show alteration in STs, their MIC<jats:sub>50<\/jats:sub> values showed twofold increases for clarithromycin and ciprofloxacin. While ciprofloxacin containing regimens were more successful, failure of metronidazole containing regimens was detected in 77% of the patients. Consequently, inappropriate medication has an impact on refractory <jats:italic>H.\u00a0pylori<\/jats:italic> infection, which could cause to a rise in resistance levels to antibiotics and progression of pathological disorders.<\/jats:p>","DOI":"10.1111\/apm.13001","type":"journal-article","created":{"date-parts":[[2019,10,19]],"date-time":"2019-10-19T14:00:02Z","timestamp":1571493602000},"page":"25-34","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Histological changes in refractory <i>Helicobacter pylori<\/i> infection and its relationship with increased levels of resistance to antibiotics and therapeutic regimens: one\u2010year follow\u2010up"],"prefix":"10.1111","volume":"128","author":[{"given":"Saeed","family":"Bayati","sequence":"first","affiliation":[{"name":"Department of Microbiology School of Medicine Iran University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masoud","family":"Alebouyeh","sequence":"additional","affiliation":[{"name":"Foodborne and Waterborne Diseases Research Center Research Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences Tehran Iran"},{"name":"Pediatric Infections Research Center Research Institute for Children's Health Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nour","family":"Amirmozafari","sequence":"additional","affiliation":[{"name":"Department of Microbiology School of Medicine Iran University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nasser","family":"Ebrahimi Daryani","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology School of Medicine Tehran University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maliheh","family":"Talebi","sequence":"additional","affiliation":[{"name":"Department of Microbiology School of Medicine Iran University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Reza","family":"Zali","sequence":"additional","affiliation":[{"name":"Gastroenterology and Liver Diseases Research Center Research Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,11,22]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"427","article-title":"Antral histopathological changes in acid peptic disease associated with Helicobacter pylori","volume":"42","author":"Mysorekar VV","year":"1999","journal-title":"Indian J Pathol Microbiol"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2004.02210.x"},{"key":"e_1_2_10_4_1","first-page":"304","article-title":"A Panorama of Helicobacter pylori infection: key messages for clinicians","volume":"58","author":"Pellicano R","year":"2016","journal-title":"Panminerva Med"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.5662\/wjm.v5.i3.164"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djs003"},{"key":"e_1_2_10_7_1","first-page":"S1","article-title":"Impacts of H. pylori mixed\u2010infection and hetero resistance on clinical outcomes","volume":"8","author":"Alebouyeh M","year":"2015","journal-title":"Gastroenterol Hepatol Bed Bench"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01131-10"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2180-5-32"},{"key":"e_1_2_10_10_1","unstructured":"Clinical and Laboratory Standards Institute (CLSI).Performance Standards for Antimicrobial Susceptibility Testing; Seventeenth informational Supplement. 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