Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 4055 Tudor Centre Dr, Anchorage, Alaska 99508. Electronic address: firstname.lastname@example.org.
Alaska Native people experience a high burden of Helicobacter pylori infection and concomitant high rates of gastric cancer. Additionally, the prevalence of antimicrobial resistant strains of H. pylori has been shown to be high in Alaska. We evaluated antimicrobial resistance over time among sentinel surveillance isolates and assessed risk factors for carrying resistant H. pylori.
Through Alaska's H. pylori sentinel surveillance system, we collected and cultured antral and fundal biopsies from Alaska Native patients undergoing esophagogastroduodenoscopy for clinical indications during 2000-2016. For positive cultures, we performed minimum inhibitory concentration (MIC) testing for metronidazole, amoxicillin, clarithromycin, tetracycline, and levofloxacin.
We tested 800H. pylori isolates obtained from 763 patients. Metronidazole resistance was most common (342/800; 43%), followed by clarithromycin resistance (238/800; 30%), resistance to both clarithromycin and metronidazole (128/800; 16%), and levofloxacin resistance (113/800; 15%). Low proportions of isolates were resistant to amoxicillin and tetracycline. Levofloxacin resistance increased between 2000 and 2016 (p