{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:05:50Z","timestamp":1784865950218,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T00:00:00Z","timestamp":1694563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p><jats:italic>Helicobacter pylori<\/jats:italic> infection is responsible for considerable morbidity and mortality worldwide and eradication rates are falling globally because of increasing antimicrobial resistance. However, there is a paucity of local data to guide the choice of eradication therapy in Australia. This study aimed to evaluate current Australian rates of <jats:italic>H. pylori<\/jats:italic> antibiotic resistance in patients who had failed prior eradication therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of routine culture and antibiotic susceptibility data from two pathology laboratories servicing multiple tertiary referral hospitals in Western Australia (WA) and South Australia (SA), between 2018 and 2022, was performed. Rates of antimicrobial resistance and prevalence of multiresistant isolates in both SA and WA were calculated and comparison of temporal trends and differences between the two states was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 796 <jats:italic>H. pylori<\/jats:italic> isolates revealed a clarithromycin resistance rate of 82%, metronidazole 68%, amoxicillin 4.4% and tetracycline 0.5%. Resistance to levofloxacin was observed in 22% and rifampicin 14%. Rates of resistance to clarithromycin were lower in SA compared with WA (incidence rate ratio [IRR]: 0.69, <jats:italic>P<\/jats:italic> =\u20090.0001). Multiresistant isolates were discovered in 63% of patients, with lower rates in SA compared with WA (IRR: 0.74, <jats:italic>P<\/jats:italic> =\u20090.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This first multicentre, multistate study of <jats:italic>H. pylori<\/jats:italic> resistance in Australian patients exposed to prior therapy demonstrated high rates of antimicrobial resistance, including levofloxacin (&gt;20%). This raises concern about recommending levofloxacin in empirical second\u2010line therapies. Increased monitoring and awareness of current <jats:italic>H. pylori<\/jats:italic> resistance rates in Australia are needed to guide local eradication practices.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.16226","type":"journal-article","created":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T13:04:51Z","timestamp":1694696691000},"page":"1972-1978","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Refractory <i>Helicobacter pylori<\/i> infection in Australia: updated multicentre antimicrobial resistance"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7201-1188","authenticated-orcid":false,"given":"Jonathon P.","family":"Schubert","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"},{"name":"Department of Gastroenterology The Queen Elizabeth Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7733-7072","authenticated-orcid":false,"given":"Paul R.","family":"Ingram","sequence":"additional","affiliation":[{"name":"Department of Microbiology PathWest Laboratory Medicine, Fiona Stanley Hospital  Perth Western Australia Australia"},{"name":"School of Pathology and Laboratory Medicine University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgyn S.","family":"Warner","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"},{"name":"Microbiology and Infectious Diseases Directorate SA Pathology  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K.","family":"Rayner","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"},{"name":"Department of Gastroenterology and Hepatology Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian C.","family":"Roberts\u2010Thomson","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2857-1812","authenticated-orcid":false,"given":"Samuel P.","family":"Costello","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"},{"name":"Department of Gastroenterology The Queen Elizabeth Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert V.","family":"Bryant","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Adelaide Medical School University of Adelaide  Adelaide South Australia Australia"},{"name":"Department of Gastroenterology The Queen Elizabeth Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-320839"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.07.007"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13497"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.15352"},{"key":"e_1_2_7_7_1","first-page":"15","article-title":"Increasing secondary resistance to fluoroquinolones amongst Helicobacter pylori in Western Australia","volume":"2","author":"Pateria P","year":"2020","journal-title":"Tasman Med J"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.15355"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.15640"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.2217\/fon-2022-0253"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.13432"},{"key":"e_1_2_7_12_1","unstructured":"Therapeutic Guidelines.Helicobacter pyloriinfection Melbourne2016 (amended 2019). 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