{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T12:20:44Z","timestamp":1781871644946,"version":"3.54.5"},"reference-count":17,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,4,6]]},"abstract":"<jats:p>This study aimed to survey the prevalence, patterns of antibiotic resistance, and clinical factors associated with antibiotic resistance in <jats:italic>Helicobacter pylori<\/jats:italic> among the Karen and Hmong mountain people of Thailand. We recruited dyspeptic patients in the Maesod district, Tak Province, Thailand. All subjects underwent upper gastrointestinal endoscopy, and three antral gastric biopsies were obtained for rapid urease tests and culture. An epsilometer was used to determine the minimum inhibitory concentrations of amoxicillin (AMX), clarithromycin (CLR), metronidazole (MNZ), levofloxacin (LVX), ciprofloxacin (CIP), and tetracycline (TET). A total of 291 subjects were enrolled; 149 (51.2%) were infected with <jats:italic>H. pylori. Helicobacter pylori<\/jats:italic> infection was present in 47.1% of Thai, 51.7% of Karen, and 58.7% of Hmong subjects. Antibiotic resistance was present in 75.8% including AMX (0.8%), TET (0%), CLR (5.6%), MNZ (71.8%), CIP (19.4%), LVX (19.4%), and multidrug resistance in 21.8%. Karen subjects had the highest prevalence of MNZ resistance (84.6%), and Hmong subjects had the highest prevalence of fluoroquinolone (27.3%) and multidrug (34.1%) resistance. MNZ plus fluoroquinolone (14.5%) was the most common multidrug resistance. There was no association between clinical factors and antibiotic resistance. MNZ resistance was prevalent, whereas fluoroquinolone- and multidrug-resistant <jats:italic>H. pylori<\/jats:italic> infections are important problems in mountain people of Thailand.<\/jats:p>","DOI":"10.4269\/ajtmh.15-0449","type":"journal-article","created":{"date-parts":[[2016,2,16]],"date-time":"2016-02-16T03:34:05Z","timestamp":1455593645000},"page":"717-720","source":"Crossref","is-referenced-by-count":11,"title":["Extremely High Prevalence of Metronidazole-Resistant Helicobacter pylori Strains in Mountain People (Karen and Hmong) in Thailand"],"prefix":"10.4269","volume":"94","author":[{"given":"Ratha-korn","family":"Vilaichone","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thawee","family":"Ratanachu-ek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pornpen","family":"Gamnarai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supakarn","family":"Chaithongrat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomahisa","family":"Uchida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshio","family":"Yamaoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varocha","family":"Mahachai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Gastroenterol Clin North Am","first-page":"229","article-title":"Helicobacter pylori diagnosis and management","volume":"35","author":"Vilaichone","year":"2006"},{"key":"ref2","series-title":"Asian Pac J Cancer Prev","first-page":"9005","article-title":"Clinical characteristics and Helicobacter pylori status of gastric cancer in Thailand","volume":"15","author":"Vilaichone","year":"2014"},{"key":"ref3","series-title":"Helicobacter Res","first-page":"38","article-title":"Current status of Helicobacter pylori infection in Thailand","volume":"15","author":"Mahachai","year":"2011"},{"key":"ref4","series-title":"J Gastroenterol Hepatol","first-page":"46","article-title":"CagA genotype and metronidazole resistant strain of Helicobacter pylori in functional dyspepsia in Thailand","volume":"3","author":"Vilaichone","year":"2011"},{"key":"ref5","series-title":"Diagn Microbiol Infect Dis","first-page":"346","article-title":"Nationwide survey of Helicobacter pylori antibiotic resistance in Thailand","volume":"77","author":"Vilaichone","year":"2013"},{"key":"ref6","series-title":"Helicobacter","first-page":"47","article-title":"Analysis of antibiotic susceptibility patterns of Helicobacter pylori isolates from Malaysia","volume":"16","author":"Ahmad","year":"2011"},{"key":"ref7","series-title":"Clin Microbiol Rev","first-page":"280","article-title":"Helicobacter pylori detection and antimicrobial susceptibility testing","volume":"20","author":"M\u00e9graud","year":"2007"},{"key":"ref8","series-title":"Helicobacter","first-page":"21","article-title":"High level of antimicrobial resistance in French Helicobacter pylori isolates","volume":"15","author":"Raymond","year":"2010"},{"key":"ref9","series-title":"Asian Pac J Cancer Prev","first-page":"10887","article-title":"Helicobacter pylori infection impacts on functional dyspepsia in Thailand","volume":"15","author":"Piriyapong","year":"2014"},{"key":"ref10","series-title":"Asian Pac J Cancer Prev","first-page":"9027","article-title":"Virulence genes of Helicobacter pylori in gastritis, peptic ulcer and gastric cancer in Laos","volume":"15","author":"Vannarath","year":"2014"},{"key":"ref11","series-title":"Helicobacter","first-page":"270","article-title":"Improved efficacy of proton pump inhibitor\u2013amoxicillin\u2013clarithromycin triple therapy for Helicobacter pylori eradication in low clarithromycin resistance areas or for tailored therapy","volume":"18","author":"Prasertpetmanee","year":"2013"},{"key":"ref12","series-title":"Expert Rev Anti Infect Ther","first-page":"59","article-title":"Geographic map and evolution of primary Helicobacter pylori resistance to antibacterial agents","volume":"8","author":"Boyanova","year":"2010"},{"key":"ref13","series-title":"Aliment Pharmacol Ther","first-page":"1221","article-title":"Is Helicobacter pylori antibiotic resistance surveillance needed and how can it be delivered?","volume":"35","author":"McNulty","year":"2012"},{"key":"ref14","series-title":"Helicobacter","first-page":"274","article-title":"Antibiotic resistance of Helicobacter pylori isolated in the southeast coastal region of China","volume":"18","author":"Su","year":"2013"},{"key":"ref15","series-title":"Asian Pac J Cancer Prev","first-page":"9909","article-title":"Improved eradication rate of standard triple therapy by adding bismuth and probiotic supplement for Helicobacter pylori treatment in Thailand","volume":"15","author":"Srinarong","year":"2014"},{"key":"ref16","series-title":"J Gastroenterol Hepatol","first-page":"825","article-title":"Sequential therapy in clarithromycin-sensitive and -resistant Helicobacter pylori based on polymerase chain reaction molecular test","volume":"26","author":"Mahachai","year":"2011"},{"key":"ref17","series-title":"Helicobacter","first-page":"282","article-title":"Pilot studies to identify the optimum duration of concomitant Helicobacter pylori eradication therapy in Thailand","volume":"17","author":"Kongchayanun","year":"2012"}],"container-title":["The American Society of Tropical Medicine and 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