| Title: |
Evaluation of real-time PCR compared to culture for the detection of clarithromycin resistant Helicobacter pylori in the Irish healthcare setting |
| Authors: |
S. Molloy, T. Butler, I. Merrigan, A. Knight, V. Parihar, K. Van Der Merwe, D. McNamara, S. Smith |
| Source: |
Microbiota in Health and Disease, Vol 5 (2023) |
| Publisher Information: |
Verduci Editore, 2023. |
| Publication Year: |
2023 |
| Collection: |
LCC:Diseases of the digestive system. Gastroenterology
LCC:Medicine (General) |
| Subject Terms: |
helicobacter pylori, clarithromycin, antimicrobial resistance, antimicrobial susceptibility testing, molecular methods, real-time pcr., Diseases of the digestive system. Gastroenterology, RC799-869, Medicine (General), R5-920 |
| More Details: |
Objective: Molecular methods offer a more rapid alternative for the detection of H. pylori resistance to antibiotics than traditional culture-based methods. The aim of the study was to evaluate the RIDAGENE H. pylori real-time PCR assay compared to culture-based methods for the detection of H. pylori and clarithromycin resistance using gastric biopsies. Patients and Methods: Following ethical approval and informed consent, adults were recruited prospectively from Tallaght University Hospital and Letterkenny University Hospital, Ireland, regardless of H. pylori treatment history. During routine gastroscopy, subjects had 1 antrum and 1 corpus biopsy taken for H. pylori culture and DNA extraction. Clarithromycin susceptibility testing on cultures was performed by ETEST (Biomerieux, UK). The RIDAGENE H. pylori assay (R-Biopharm AG, Germany) was used for detection of H. pylori DNA and clarithromycin resistance-associated point mutations. Results: In all, samples from 191 culture-positive patients (mean age 48.4 ± 15.3 years; 45.0% (N=86) female) were analysed. The RIDAGENE assay detected H. pylori in 100% of biopsy samples from which H. pylori was cultured. The clarithromycin resistance rate by culture was significantly higher than by real-time PCR (49.2% (N=94/191) and 38.7% (N=74/191, respectively; p=0.04; χ2 test). Results agreed between both methods in 84.3% (N=161/191) of cases. The sensitivity and specificity of the RIDAGENE assay compared to culture for the detection of clarithromycin resistance were 74.0% (95% CI: 64.0-82.4%) and 94.7% (95% CI: 88.1-98.3%), respectively. The positive predictive value was 93.4% (95% CI: 85.7-97.1%) and the negative predictive value was 78.3% (95% CI: 71.9-83.5%). Conclusions: The RIDAGENE assay detected H. pylori in all culture-positive samples. However, the low sensitivity compared to culture for clarithromycin susceptibility testing in our cohort may limit its use to cases where culture-based methods are unsuccessful. Further studies are required to fully characterise H. pylori clarithromycin resistance mechanisms in our study population. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2704-8845 |
| Relation: |
https://www.microbiotajournal.com/wp-content/uploads/sites/7/2023/11/e956-1.pdf; https://doaj.org/toc/2704-8845 |
| DOI: |
10.26355/mhd_202311_956 |
| Access URL: |
https://doaj.org/article/057502326d564ccb8a48abd481e53e63 |
| Accession Number: |
edsdoj.057502326d564ccb8a48abd481e53e63 |
| Database: |
Directory of Open Access Journals |
