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Article ; Online: Helicobacter pylori in early childhood and asthma in adolescence.

Melby, Kjetil K / Carlsen, Karin L / Håland, Geir / Samdal, Helvi H / Carlsen, Kai-Håkon

2020 Volume 13, Issue 1, Page(s) 79

Abstract: Objective: An inverse effect of Helicobacter pylori (H. pylori) on the occurrence of asthma is debated and early acquisition of H. pylori may be important. We analyzed sera from 197 children from Environment and Childhood Asthma (ECA) study in Oslo for ... ...

Abstract	Objective: An inverse effect of Helicobacter pylori (H. pylori) on the occurrence of asthma is debated and early acquisition of H. pylori may be important. We analyzed sera from 197 children from Environment and Childhood Asthma (ECA) study in Oslo for Helicobacter pylori (H. pylori) at 2 and 10 years, and symptoms and signs of asthma at 16 years of age. Results: While 16.4% of children who were H. pylori negative at 2 and 10 years had current asthma at 16 years, none of the 12 children who were H. pylori positive at 2 years of age had asthma at the age of 16 years, regardless of H. pylori status at 10 years. This trend for less current asthma in children who were H. pylori positive at 2 years compared to persistent or transient negative status at 10 years was not statistically significant, probably due to low number of H. pylori positive children at 2 years of age. Acquisition of H. pylori in school age did not appear to influence the risk of current asthma. Much larger prospective studies are probably required to document whether or not early H. pylori infection may be involved in the risk of asthma development in later childhood.
MeSH term(s)	Adolescent ; Asthma/blood ; Asthma/epidemiology ; Asthma/microbiology ; Child ; Child, Preschool ; Helicobacter Infections/blood ; Helicobacter Infections/epidemiology ; Helicobacter pylori/physiology ; Humans ; Immunoglobulin G/blood
Chemical Substances	Immunoglobulin G
Language	English
Publishing date	2020-02-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2413336-X
ISSN	1756-0500 ; 1756-0500
ISSN (online)	1756-0500
ISSN	1756-0500
DOI	10.1186/s13104-020-04941-6
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Article ; Online: Helicobacter pylori resistance to antibiotics before and after treatment: Incidence of eradication failure.

Nestegard, Oddmund / Moayeri, Behrouz / Halvorsen, Fred-Arne / Tønnesen, Tor / Sørbye, Sveinung Wergeland / Paulssen, Eyvind / Johnsen, Kay-Martin / Goll, Rasmus / Florholmen, Jon Ragnar / Melby, Kjetil K

PloS one

2022 Volume 17, Issue 4, Page(s) e0265322

Abstract: Background: Increasing prevalence of antibiotic resistance especially to clarithromycin and metronidazole has been observed in Helicobacter pylori (H. pylori).: Aim: To characterize the antimicrobial resistance pattern of H. pylori before and after ... ...

Abstract	Background: Increasing prevalence of antibiotic resistance especially to clarithromycin and metronidazole has been observed in Helicobacter pylori (H. pylori). Aim: To characterize the antimicrobial resistance pattern of H. pylori before and after treatment in a cohort of patients accumulated over a period of 15 years after an unsuccessful eradication treatment had been given comparing sensitivity data from patients with newly diagnosed H. pylori infection. A specific objective was to look for resistance to levofloxacin. Material and methods: Total of 50 patients newly diagnosed for H. pylori infection treated with omeprazole and amoxicillin/clarithromycin and 42 H pylori treatment-resistant patients treated with omeprazole and amoxicillin/levofloxacin were enrolled in this study. Cultures including antibiotic sensitivity testing were conducted according to standard laboratory routines and thus also in keeping with a European study protocol using E-test gradient strips or disc diffusion methods. Results: Clarithromycin resistance was more frequently observed in the H. pylori resistant group than in newly diagnosed H. pylori group (39% versus 11%). Regarding metronidazole the distribution was 70% versus 38%, and 8% versus 12% were resistant to tetracycline. No resistance was observed for amoxicillin. After re-treatment of patients belonging to the H. pylori treatment-resistant group, just two patient strains were recovered of which one harbored metronidazole resistance. In the group of newly diagnosed H. pylori, seven patients were culture positive by control after treatment. Two and three patient strains showing resistance to clarithromycin and metronidazole, respectively. None of the strains in our material was classified as resistant to amoxicillin and levofloxacin. Whereas 12% was resistant to tetracycline in the newly diagnosed before treatment. Conclusion: Clarithromycin resistance was more frequent in the H. pylori treatment-resistant group than strains from patients with newly diagnosed H. pylori infection. No resistance was observed to amoxicillin and levofloxacin. In such cases Therefore levofloxacin may be used provided in vitro sensitivity testing confirms applicability. Trial registration: ClinicalTrials.gov identifier: NCT05019586.
MeSH term(s)	Amoxicillin/pharmacology ; Amoxicillin/therapeutic use ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Clarithromycin/pharmacology ; Clarithromycin/therapeutic use ; Drug Resistance, Bacterial ; Helicobacter Infections/diagnosis ; Helicobacter Infections/drug therapy ; Helicobacter Infections/epidemiology ; Helicobacter pylori ; Humans ; Incidence ; Levofloxacin/therapeutic use ; Metronidazole/pharmacology ; Metronidazole/therapeutic use ; Microbial Sensitivity Tests ; Omeprazole ; Protein Synthesis Inhibitors ; Tetracycline
Chemical Substances	Anti-Bacterial Agents ; Protein Synthesis Inhibitors ; Metronidazole (140QMO216E) ; Levofloxacin (6GNT3Y5LMF) ; Amoxicillin (804826J2HU) ; Tetracycline (F8VB5M810T) ; Clarithromycin (H1250JIK0A) ; Omeprazole (KG60484QX9)
Language	English
Publishing date	2022-04-20
Publishing country	United States
Document type	Clinical Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0265322
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Article ; Online: Borrelia--serologiske undersøkelser til nytte og besvaer.

Melby, Kjetil K / Skar, Anne Grete

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

2009 Volume 129, Issue 20, Page(s) 2135

Title translation	Borrelia--serologic tests for benefit and problems.
MeSH term(s)	Antibodies, Bacterial ; Borrelia burgdorferi/immunology ; Borrelia burgdorferi/isolation & purification ; Humans ; Lyme Disease/diagnosis ; Lyme Disease/microbiology ; Sensitivity and Specificity ; Serologic Tests ; Serotyping
Chemical Substances	Antibodies, Bacterial
Language	Norwegian
Publishing date	2009-10-22
Publishing country	Norway
Document type	Letter
ZDB-ID	603504-8
ISSN	0807-7096 ; 0029-2001
ISSN (online)	0807-7096
ISSN	0029-2001
DOI	10.4045/tidsskr.09.1060
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Article ; Online: Clinical characterization of Helicobacter pylori infected patients 15 years after unsuccessful eradication.

Nestegard, Oddmund / Johnsen, Kay-Martin / Sørbye, Sveinung W / Halvorsen, Fred-Arne / Tønnessen, Tor / Paulssen, Eyvind J / Melby, Kjetil K / Goll, Rasmus / Florholmen, Jon

PloS one

2020 Volume 15, Issue 9, Page(s) e0238944

Abstract: Background and aims: Patients that have failed therapy for Helicobacter pylori (H. pylori) infection are incompletely characterized. The aim of this study was to characterize a H. pylori treatment resistant cohort compared to the cohorts of newly ... ...

Abstract	Background and aims: Patients that have failed therapy for Helicobacter pylori (H. pylori) infection are incompletely characterized. The aim of this study was to characterize a H. pylori treatment resistant cohort compared to the cohorts of newly diagnosed, earlier eradicated and non-infected. Material and methods: Patients were selected from routine referrals to the Endoscopy units at three different Norwegian hospitals. In all four cohorts, gastric biopsies were scored according to the Sydney classification, and symptoms according to the Gastrointestinal Symptom Rating Scale score, including sub-scores for upper gastrointestinal symptoms and functional bowel symptoms. Patients in the H. pylori resistant group were treated with a triple therapy regimen that consisted of levofloxacin, amoxicillin and a proton pump inhibitor. Results: We included 185 patients, 42 H. pylori treatment resistant, 50 newly diagnosed, 61 previously H. pylori eradicated and 32 never infected. The treatment-resistant cohort had higher scores for upper gastrointestinal symptoms and functional bowel symptoms compared to the other groups except for the group being never H. pylori infected. The H. pylori resistant patients had lower Sydney scores than patients with newly diagnosed H. pylori infection. The triple combination showed a high efficacy of 91% to eradicate H. pylori. Conclusions: Patients with treatment-resistant H. pylori infection had more gastrointestinal symptoms, but a lower Sydney score than patients with newly diagnosed infection. A treatment regimen including levofloxacin showed a high efficacy in eradicating H. pylori in patients that previously had failed eradication treatment.
MeSH term(s)	Aged ; Amoxicillin/therapeutic use ; Anti-Bacterial Agents/pharmacology ; Drug Resistance, Bacterial/drug effects ; Drug Therapy, Combination ; Female ; Helicobacter Infections/drug therapy ; Helicobacter Infections/metabolism ; Helicobacter Infections/physiopathology ; Helicobacter pylori/drug effects ; Helicobacter pylori/metabolism ; Helicobacter pylori/pathogenicity ; Humans ; Levofloxacin/therapeutic use ; Male ; Middle Aged ; Proton Pump Inhibitors/therapeutic use
Chemical Substances	Anti-Bacterial Agents ; Proton Pump Inhibitors ; Levofloxacin (6GNT3Y5LMF) ; Amoxicillin (804826J2HU)
Language	English
Publishing date	2020-09-23
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0238944
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Article ; Online: Maternal Colonization with Group B Streptococcus Is Associated with an Increased Rate of Infants Transferred to the Neonatal Intensive Care Unit.

Brigtsen, Anne Karin / Jacobsen, Anne Flem / Dedi, Lumnije / Melby, Kjetil K / Fugelseth, Drude / Whitelaw, Andrew

Neonatology

2015 Volume 108, Issue 3, Page(s) 157–163

Abstract: Background: Streptococcus agalactiae (group B Streptococcus, GBS) is the most common cause of early neonatal infection, but restricting the diagnosis to culture-positive infants may underestimate the burden of GBS disease. Our objective was to determine ...

Abstract	Background: Streptococcus agalactiae (group B Streptococcus, GBS) is the most common cause of early neonatal infection, but restricting the diagnosis to culture-positive infants may underestimate the burden of GBS disease. Our objective was to determine whether maternal GBS colonization was associated with an increased risk of transfer of term infants to the neonatal intensive care unit (NICU) and, if so, to estimate the incidence of probable early-onset GBS disease. Methods: We conducted a prospective cohort study of 1,694 term infants whose mothers had vaginal-rectal swabs collected at delivery. Data collected on each mother and infant included demographics, clinical findings and laboratory investigations. The medical staff were unaware of the maternal GBS colonization status. Results: A total of 26% of the mothers were colonized. Infants born to colonized mothers did not differ from infants born to non-colonized mothers with respect to birth weight or Apgar score. Altogether, 30 (1.8%) of the term infants were transferred to the NICU. Only 1 infant born to a colonized mother had culture-positive early-onset GBS disease. Infants born to colonized mothers were more than 3 times as likely to be transferred to the NICU compared to infants of non-colonized mothers (3.6 vs. 1.1%; OR 3.4, 95% CI 1.6-6.9, p = 0.001); 5 infants of colonized mothers had probable GBS disease with tachypnoea and raised C-reactive protein (3.0/1,000 live term births). Conclusions: Maternal GBS colonization is associated with increased risk of transfer to the NICU in term infants. The burden of neonatal GBS disease may be greater than indicated by the number of culture-positive cases.
MeSH term(s)	Adult ; C-Reactive Protein/analysis ; Delivery, Obstetric ; Early Diagnosis ; Female ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; Intensive Care Units, Neonatal/organization & administration ; Logistic Models ; Male ; Mothers ; Norway ; Patient Transfer/statistics & numerical data ; Pregnancy ; Prospective Studies ; Streptococcal Infections/epidemiology ; Streptococcus agalactiae/isolation & purification ; Term Birth
Chemical Substances	C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2015
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2266911-5
ISSN	1661-7819 ; 1661-7800
ISSN (online)	1661-7819
ISSN	1661-7800
DOI	10.1159/000434716
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Article ; Online: Resistensutvikling må overvåkes--gonokokken som eksempel.

Melby, Kjetil K / Olsen, Anne O / Dedi, Lumnije / Gaustad, Peter / Syversen, Gaute / Moi, Harald

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

2014 Volume 134, Issue 5, Page(s) 507–508

Title translation	The development of resistance must be monitored--gonococci as an example.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Drug Resistance, Bacterial ; Drug Utilization/standards ; Humans ; Neisseria gonorrhoeae/drug effects ; Sentinel Surveillance
Chemical Substances	Anti-Bacterial Agents
Language	Norwegian
Publishing date	2014-03-11
Publishing country	Norway
Document type	Journal Article
ZDB-ID	603504-8
ISSN	0807-7096 ; 0029-2001
ISSN (online)	0807-7096
ISSN	0029-2001
DOI	10.4045/tidsskr.14.0033
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Article ; Online: Comparison of PCR with culture applied on nasopharyngeal and throat swab specimens for the detection of Bordetella pertussis.

Holberg-Petersen, Mona / Jenum, Pål A / Mannsåker, Turid / Melby, Kjetil K

Scandinavian journal of infectious diseases

2011 Volume 43, Issue 3, Page(s) 221–224

Abstract: An in-house nested polymerase chain reaction (PCR) was prospectively compared with culture for Bordetella pertussis detection in 435 nasopharyngeal and/or throat swabs from 304 patients. One hundred specimens - 21% of nasopharyngeal swabs and 25% of ... ...

Abstract	An in-house nested polymerase chain reaction (PCR) was prospectively compared with culture for Bordetella pertussis detection in 435 nasopharyngeal and/or throat swabs from 304 patients. One hundred specimens - 21% of nasopharyngeal swabs and 25% of throat swabs - were PCR- and/or culture-positive. Seventy percent of positive nasopharyngeal samples and 44% of positive throat samples were culture-positive.
MeSH term(s)	Adolescent ; Adult ; Aged ; Bacteriological Techniques/methods ; Bordetella pertussis/genetics ; Bordetella pertussis/growth & development ; Bordetella pertussis/isolation & purification ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Middle Aged ; Nasopharynx/microbiology ; Pharynx/microbiology ; Polymerase Chain Reaction/methods ; Sensitivity and Specificity ; Young Adult
Language	English
Publishing date	2011-03
Publishing country	England
Document type	Comparative Study ; Evaluation Studies ; Journal Article
ZDB-ID	390956-6
ISSN	1651-1980 ; 0036-5548
ISSN (online)	1651-1980
ISSN	0036-5548
DOI	10.3109/00365548.2010.538855
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Article ; Online: Age-related differences in symptoms, diagnosis and prognosis of bacteremia.

Wester, Astrid L / Dunlop, Oona / Melby, Kjetil K / Dahle, Ulf R / Wyller, Torgeir Bruun

BMC infectious diseases

2013 Volume 13, Page(s) 346

Abstract: Background: Elderly patients are at particular risk for bacteremia and sepsis. Atypical presentation may complicate the diagnosis. We studied patients with bacteremia, in order to assess possible age-related effects on the clinical presentation and ... ...

Abstract	Background: Elderly patients are at particular risk for bacteremia and sepsis. Atypical presentation may complicate the diagnosis. We studied patients with bacteremia, in order to assess possible age-related effects on the clinical presentation and course of severe infections. Methods: We reviewed the records of 680 patients hospitalized between 1994 and 2004. All patients were diagnosed with bacteremia, 450 caused by Escherichia coli and 230 by Streptococcus pneumoniae. Descriptive analyses were performed for three age groups (< 65 years, 65-84 years, ≥ 85 years). In multivariate analyses age was dichotomized (< 65, ≥ 65 years). Symptoms were categorized into atypical or typical. Prognostic sensitivity of CRP and SIRS in identifying early organ failure was studied at different cut-off values. Outcome variables were organ failure within one day after admission and in-hospital mortality. Results: The higher age-groups more often presented atypical symptoms (p <0.001), decline in general health (p=0.029), and higher in-hospital mortality (p<0.001). The prognostic sensitivity of CRP did not differ between age groups, but in those ≥ 85 years the prognostic sensitivity of two SIRS criteria was lower than that of three criteria. Classical symptoms were protective for early organ failure (OR 0.67, 95% CI 0.45-0.99), and risk factors included; age ≥ 65 years (OR 1.65, 95% CI 1.09-2.49), comorbid illnesses (OR 1.19, 95% CI 1.02-1.40 per diagnosis), decline in general health (OR 2.28, 95% CI 1.58-3.27), tachycardia (OR 1.50, 95% CI 1.02-2.20), tachypnea (OR 3.86, 95% CI 2.64-5.66), and leukopenia (OR 4.16, 95% CI 1.59-10.91). Fever was protective for in-hospital mortality (OR 0.46, 95% CI 0.24-0.89), and risk factors included; age ≥ 65 years (OR 15.02, 95% CI 3.68-61.29), ≥ 1 comorbid illness (OR 2.61, 95% CI 1.11-6.14), bacteremia caused by S. pneumoniae (OR 2.79, 95% CI 1.43-5.46), leukopenia (OR 4.62, 95% CI 1.88-11.37), and number of early failing organs (OR 3.06, 95% CI 2.20-4.27 per failing organ). Conclusions: Elderly patients with bacteremia more often present with atypical symptoms and reduced general health. The SIRS-criteria have poorer sensitivity for identifying organ failure in these patients. Advanced age, comorbidity, decline in general health, pneumococcal infection, and absence of classical symptoms are markers of a poor prognosis.
MeSH term(s)	Adult ; Age Factors ; Aged ; Aged, 80 and over ; Bacteremia/diagnosis ; Escherichia coli Infections/diagnosis ; Humans ; Middle Aged ; Multivariate Analysis ; Pneumococcal Infections/diagnosis ; Prognosis ; Retrospective Studies ; Sepsis/diagnosis
Language	English
Publishing date	2013-07-24
Publishing country	England
Document type	Journal Article
ISSN	1471-2334
ISSN (online)	1471-2334
DOI	10.1186/1471-2334-13-346
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Article ; Online: Resistance rates of metronidazole and other antibacterials in Helicobacter pylori from previously untreated patients in Norway.

Larsen, Astri L / Ragnhildstveit, Eivind / Moayeri, Berouz / Eliassen, Lisbeth / Melby, Kjetil K

APMIS : acta pathologica, microbiologica, et immunologica Scandinavica

2013 Volume 121, Issue 4, Page(s) 353–358

Abstract: The aim of the study was to describe the antimicrobial resistance rate of Helicobacter pylori isolated from previously untreated patients in Norway, including the application of two different methods for the determination of metronidazole susceptibility. ...

Abstract	The aim of the study was to describe the antimicrobial resistance rate of Helicobacter pylori isolated from previously untreated patients in Norway, including the application of two different methods for the determination of metronidazole susceptibility. Altogether 102 isolates obtained in 2008 and 2009 from previously untreated patients suspected of H. pylori related disease, were examined applying a standardized European study protocol. The activity of amoxicillin, tetracycline, clarithromycin, metronidazole, rifabutin and levofloxacin was recorded after an incubation period of 72-96 h in a microaerobic atmosphere. Strains resistant to metronidazole were re-examined for metronidazole resistance applying anaerobic conditions for the first 24 h. None of the isolates were resistant to amoxicillin or tetracycline, whereas 5, 9% were resistant to clarithromycin and 22, 5% resistant to metronidazole tested conventionally. Applying local standards the metronidazole resistance rate fell to 7, 8%, highlighting the importance of the methodology applied for metronidazole susceptibility testing.
MeSH term(s)	Anti-Infective Agents/pharmacology ; Drug Resistance, Bacterial ; Helicobacter Infections/drug therapy ; Helicobacter pylori/drug effects ; Humans ; Metronidazole/pharmacology ; Microbial Sensitivity Tests ; Norway
Chemical Substances	Anti-Infective Agents ; Metronidazole (140QMO216E)
Language	English
Publishing date	2013-04
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	93340-5
ISSN	1600-0463 ; 0903-4641
ISSN (online)	1600-0463
ISSN	0903-4641
DOI	10.1111/apm.12009
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Article: Susceptibility to daptomycin, quinupristin-dalfopristin and linezolid and some other antibiotics in clinical isolates of methicillin resistant and methicillin sensitive S.aureus from the Oslo area.

Jørgen, Bente / Merckoll, Patricia / Melby, Kjetil K

Scandinavian journal of infectious diseases

2007 Volume 39, Issue 11-12, Page(s) 1059–1062

Abstract: Our study compared the susceptibility of 136 clinical isolates of Staphylococcus aureus and 119 multidrug-resistant Staphylococcus aureus (MRSA) isolates from Oslo to a range of antibiotics, including the novel antibiotics quinupristin-dalfopristin, ... ...

Abstract	Our study compared the susceptibility of 136 clinical isolates of Staphylococcus aureus and 119 multidrug-resistant Staphylococcus aureus (MRSA) isolates from Oslo to a range of antibiotics, including the novel antibiotics quinupristin-dalfopristin, linezolid and daptomycin. All isolates were susceptible to daptomycin, linezolid and quinupristin-dalfopristin, although a subgroup was less susceptible to the latter. There was no linkage between reduced susceptibility to daptomycin, linezolid or quinupristin-dalfopristin and resistance to other classes of antimicrobials. In addition, MRSA strains from 2004 have become more sensitive to fucidin and rifampicin. The results can be used to evaluate the appropriateness of breakpoints and to define a baseline for monitoring possible future emergence of resistance to daptomycin, quinupristin-dalfopristin and linezolid in Staphylococcus aureus in Norway.
MeSH term(s)	Acetamides/pharmacology ; Anti-Bacterial Agents/pharmacology ; Daptomycin/pharmacology ; Humans ; Linezolid ; Methicillin Resistance ; Norway/epidemiology ; Oxazolidinones/pharmacology ; Staphylococcal Infections/epidemiology ; Staphylococcal Infections/microbiology ; Staphylococcus aureus/drug effects ; Virginiamycin/pharmacology
Chemical Substances	Acetamides ; Anti-Bacterial Agents ; Oxazolidinones ; Virginiamycin (11006-76-1) ; quinupristin-dalfopristin (126602-89-9) ; Linezolid (ISQ9I6J12J) ; Daptomycin (NWQ5N31VKK)
Language	English
Publishing date	2007
Publishing country	England
Document type	Journal Article
ZDB-ID	390956-6
ISSN	1651-1980 ; 0036-5548
ISSN (online)	1651-1980
ISSN	0036-5548
DOI	10.1080/00365540701466231
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