This study recruited 593 patients undergoing gastroscopy between February 2012 and October 2012 and determined the prevalence of primary Helicobacter pylori (H. pylori) infection from all Campylobacter-like organism (CLO) tests performed. All patients were attending the Counties Manukau District Health Board (South Auckland) Endoscopy Service. The prevalence of H. pylori infection by ethnic group was 7.7% in Europeans, 34.8% in Māori, 31.3% in Pacific peoples and 23.8% in Orientals. Almost half (49.3%) of all isolates were metronidazole-resistant, 16.4% were clarithromycin-resistant and 9.5% were moxifloxacin-resistant. No isolates were resistant to tetracycline. Clarithromycin resistance (≥15%) was prevalent among Māori, Pacific peoples and Orientals. Significant increases were observed in metronidazole resistance from 32.7% in 1999 to 49.3% in 2012 (p=0.011) and clarithromycin resistance from 7% in 1999 to 16.4% in 2012 (p=0.021). In an intent-to-treat analysis, the eradication rate with standard omeprazole, amoxicillin and clarithromycin therapy was 85.7% in ethnic groups where clarithromycin resistance was <15% versus 64.9% in groups where clarithromycin resistance was ≥15% (p=0.024).
