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      Helicobacter pylori and antimicrobial resistance: molecular mechanisms and clinical implications.

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          Abstract

          Helicobacter pylori is an important human pathogen that colonises the stomach of about half of the world's population. The bacterium has now been accepted as the causative agent of several gastroduodenal disorders, ranging from chronic active gastritis and peptic ulcer disease to gastric cancer. The recognition of H pylori as a gastric pathogen has had a substantial effect on gastroenterological practice, since many untreatable gastroduodenal disorders with uncertain cause became curable infectious diseases. Treatment of H pylori infection results in ulcer healing and can reduce the risk of gastric cancer development. Although H pylori is susceptible to many antibiotics in vitro, only a few antibiotics can be used in vivo to cure the infection. The frequent indication for anti-H pylori therapy, together with the limited choice of antibiotics, has resulted in the development of antibiotic resistance in H pylori, which substantially impairs the treatment of H pylori-associated disorders. Antimicrobial resistance in H pylori is widespread, and although the prevalence of antimicrobial resistance shows regional variation per antibiotic, it can be as high as 95%. We focus on the treatment of H pylori infection and on the clinical relevance, mechanisms, and diagnosis of antimicrobial resistance.

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          Author and article information

          Journal
          Lancet Infect Dis
          The Lancet. Infectious diseases
          Elsevier BV
          1473-3099
          1473-3099
          Nov 2006
          : 6
          : 11
          Affiliations
          [1 ] Department of Gastroenterology and Hepatology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, Netherlands.
          Article
          S1473-3099(06)70627-2
          10.1016/S1473-3099(06)70627-2
          17067919
          97709e46-9818-4cfb-ae4a-c42394b35f49
          History

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