{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T08:07:39Z","timestamp":1770883659538,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T00:00:00Z","timestamp":1562803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Antimicrobial resistance of <jats:italic>Helicobacter pylori<\/jats:italic> reduces the eradication rate. This study aimed to investigate changes in antimicrobial susceptibility of <jats:italic>H\u00a0pylori<\/jats:italic> isolated from children in Taiwan in the past two decades.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study enrolled children receiving esophagogastroduodenoscopy for upper gastrointestinal diseases in a national tertiary referring hospital from 1998 to 2018. <jats:italic>H\u00a0pylori<\/jats:italic> infection was diagnosed by culture. The minimal inhibitory concentrations (MICs) of antibiotics were tested using the <jats:italic>E<\/jats:italic> test. The antibiotic resistance rates and MICs of amoxicillin, clarithromycin, metronidazole, levofloxacin, and tetracycline were compared between 1998\u20102008 and 2009\u20102018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 70 <jats:italic>Helicobacter pylori<\/jats:italic> isolates (29 from 1998 to 2008 and 41 from 2009 to 2018) were identified. The esophagogastroduodenoscopy findings included duodenal ulcers (n\u00a0=\u00a031), gastric ulcers (n\u00a0=\u00a09), and gastritis (n\u00a0=\u00a030). The overall antimicrobial resistance rates of clarithromycin and metronidazole were 22.9% and 21.4%, respectively. The dual resistance rate of clarithromycin and metronidazole was 10%. Resistance rates of levofloxacin and amoxicillin were 8.3% and 2.9%, respectively. None of the isolates were resistant to tetracycline. Compared with the isolates from 1998 to 2008, those from 2009 to 2018 had higher MICs and resistance rates of clarithromycin (26.8% vs 17.2%, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.35) and metronidazole (26.8% vs 13.8%, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.19), but not levofloxacin (9.8% vs 5.3%, <jats:italic>P<\/jats:italic>\u00a0=\u00a01.0) or coresistance to clarithromycin and metronidazole (12.2% vs 6.9%, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.69).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The antimicrobial resistance rates of pediatric <jats:italic>H\u00a0pylor<\/jats:italic>i isolates to clarithromycin and metronidazole increased during the past decade. The selection of antimicrobial agents other than clarithromycin and metronidazole is crucial to increase pediatric <jats:italic>H\u00a0pylori<\/jats:italic> eradication rates.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.12633","type":"journal-article","created":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T22:58:47Z","timestamp":1562885927000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Increasing antimicrobial resistance to clarithromycin and metronidazole in pediatric <i>Helicobacter pylori<\/i> infection in southern Taiwan: A comparison between two decades"],"prefix":"10.1111","volume":"24","author":[{"given":"Hsiao\u2010Han","family":"Lu","sequence":"first","affiliation":[{"name":"Departments of Pediatrics National Cheng Kung University Hospital, Medical College National Cheng Kung University Tainan 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