Detection of Clarithromycin‐Resistant <i>Helicobacter pylori</i> by Stool <scp>PCR</scp> in Children: A Comprehensive Review of Literature

Xiong, Lilin; Yu, Tong; Wang, Zhong Lin; Mao, Meng

doi:10.1111/hel.12016

Cited by 25 publications

(31 citation statements)

References 65 publications

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“…However, in USA, CLA resistance was found in only 8.6% [36, 37]. Some researchers have reported that a higher prevalence of resistance to both CLA and FLQ was detected in samples from stool compared to biopsy, and they suggested that this could be related to the existence of mixed infections with both resistant and susceptible strains [38]. Whereas this could partly explain our findings, it also could imply that when patients harbouring mixed infections receive antibiotics, the resistant strains naturally become selected for making the drug resistant problem even worse.…”

Section: Discussionmentioning

confidence: 99%

Helicobacter pylori from Peptic Ulcer Patients in Uganda Is Highly Resistant to Clarithromycin and Fluoroquinolones: Results of the GenoType HelicoDR Test Directly Applied on Stool

Angol

Ocama

Kirabo

et al. 2017

BioMed Research International

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Background Around 70–90% of peptic ulcer disease (PUD) is due to Helicobacter pylori and requires treatment with antimicrobials to which these bacteria are susceptible. Common H. pylori diagnostic tests do not provide drug susceptibility data. Using the GenoType HelicoDR PCR test designed for gastric biopsies for simultaneous detection of H. pylori and its resistance to clarithromycin (CLA)/fluoroquinolones (FLQ), we present evidence for stool as an optional test specimen and also provide data on prevalence of H. pylori resistance to CLA and FLQ in Uganda. Methods Stool from 142 symptomatic PUD patients at three hospitals in Kampala was screened for H. pylori using a rapid antigen test. The GenoType HelicoDR test was run on all H. pylori antigen positives to determine PCR positivity and resistance to CLA/FLQ. Results Thirty-one samples (22%) were H. pylori antigen positive, and 21 (68%) of these were H. pylori PCR positive. Six of the 21 (29%) were resistant to CLA and eight to FLQ (42%), while two gave invalid FLQ resistance results. Conclusion Stool is a possible specimen for the GenoType HelicoDR test for rapid detection of H. pylori and drug resistance. In Uganda, Helicobacter pylori is highly resistant to CLA and FLQ.

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Section: Discussionmentioning

confidence: 99%

Helicobacter pylori from Peptic Ulcer Patients in Uganda Is Highly Resistant to Clarithromycin and Fluoroquinolones: Results of the GenoType HelicoDR Test Directly Applied on Stool

Angol

Ocama

Kirabo

et al. 2017

BioMed Research International

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“…The presence of polymerase inhibitors in the biological sample and possible contamination during sample collection present obstacles to overcome. Currently, the clinical use of PCR-based testing is limited by the expensive costs, but the high diagnostic performance in the pre-and post-treatment setting, with additional option of identifying clarithromycinresistant strains, renders it an excellent future diagnostic method, particularly in children [32].…”

Section: Research Polymerase Chain Reaction (Pcr)mentioning

confidence: 99%

Helicobacter Pylori Infection: Diagnostic Strategies in Primary Diagnosis and After Therapy

Atkinson

Braden

2015

Dig Dis Sci

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Accurate diagnosis of Helicobacter pylori infection pre- and post-treatment is mandatory in the current era of decreasing prevalence and increasing antibiotic resistance. The diagnostic performance of most tests is poorer in clinical situations with low bacterial density which is seen in conditions such as atrophic gastritis or intake of antisecretory and antibiotic medications. Noninvasive tests require less cost and resource but provide excellent accuracy; however, endoscopy with testing of gastric biopsy specimens is indicated where alarming symptoms are present or antibiotic susceptibility testing by culture is desired. Newer modalities such as polymerase chain reaction testing provide additional virulence and antibiotic sensitivity profiling. This article outlines new developments and the key parameters of each test, as careful selection of test modality within the clinical context is required for adequate management of infected symptomatic patients.

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“…Another criticism of our study relates to the clinical relevance of in vitro testing; however, with the exception of MET, the concern that susceptibility results do not predict treatment efficacy is largely unfounded (33)(34)(35)(36). Furthermore, the future of susceptibility testing may be noninvasive stool PCR-based testing, which will obviate direct culture (37). A future study might be enhanced by including resistance data for additional antibiotics which are sometimes used to treat refractory H. pylori, such as furazolidone, rifabutin, and nitazoxanide (38)(39)(40).…”

Section: Discussionmentioning

confidence: 95%

Trends in Secondary Antibiotic Resistance of Helicobacter pylori from 2007 to 2014: Has the Tide Turned?

et al. 2015

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The current guidelines recommend culture and antibiotic susceptibility testing of Helicobacter pylori following two failed eradication attempts. Where testing is unavailable, epidemiological data for secondary H. pylori resistance are essential to allow for the rational use of antibiotics. The aim of this study was to describe the temporal changes in antibiotic resistance among adults previously treated for H. pylori infections and to identify predictors of resistance. Between 2007 and 2014, consecutive patients undergoing gastroscopy with H. pylori culture and susceptibility testing at our institution following at least two treatment failures were retrospectively identified. Antibiotic susceptibilities were recorded and linked to the demographic data. A total of 1,042 patients were identified, including 739 (70.9%) males, aged 39.3 ؎ 18.9 years. Resistance to clarithromycin, metronidazole, and levofloxacin was found in 57.2%, 64.4%, and 5.1% of isolates, respectively. Dual resistance to clarithromycin and metronidazole was seen in 39.9%. Over the study period, clarithromycin resistance increased annually in a linear manner (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.03 to 1.14; P < 0.01), levofloxacin resistance decreased annually (OR, 0.78; 95% CI, 0.61 to 0.92; P < 0.01), and metronidazole resistance was nonlinear. Age was an independent predictor of resistance to all antibiotics. Time elapsed predicted resistance for clarithromycin and levofloxacin and dual resistance for clarithromycinmetronidazole. Secondary resistance of H. pylori to clarithromycin and metronidazole remains high. The low secondary resistance to levofloxacin makes it an attractive treatment option in our region for patients following two failed eradication attempts.

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Detection of Clarithromycin‐Resistant Helicobacter pylori by Stool PCR in Children: A Comprehensive Review of Literature

Abstract: Detection of clarithromycin-resistant H. pylori by stool PCR for children are reliable, rapid, noninvasive methods that are worthy of further clinical promotion. However, more evaluations of stool PCR in detection of clarithromycin-resistant H. pylori in children need to be conducted.

Cited by 25 publications

References 65 publications

Helicobacter pylori from Peptic Ulcer Patients in Uganda Is Highly Resistant to Clarithromycin and Fluoroquinolones: Results of the GenoType HelicoDR Test Directly Applied on Stool

Helicobacter pylori from Peptic Ulcer Patients in Uganda Is Highly Resistant to Clarithromycin and Fluoroquinolones: Results of the GenoType HelicoDR Test Directly Applied on Stool

Helicobacter Pylori Infection: Diagnostic Strategies in Primary Diagnosis and After Therapy

Trends in Secondary Antibiotic Resistance of Helicobacter pylori from 2007 to 2014: Has the Tide Turned?

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