Prevalence of Helicobacter pylori in symptomatic patients and detection of clarithromycin resistance using melting curve analysis.

Background:Clarithromycin is often a component of combination therapies for Helicobacter pylori eradication; however, increases in resistance rates have decreased the success of the treatment.Objective:This study was designed to determine the prevalence of H pylori infection in symptomatic patients...

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Publicado en:Current Therapeutic Research Vol. 68; no. 3; pp. 151 - 161
Autores principales: Kaya AD, Öztürk CE, Akcan Y, Behçet M, Karakoç AE, Yücel M, Misirlioglu M, Tuncer S
Formato: research tables/charts Journal Article
Publicado: Elsevier B.V. May2007
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2007
      vid: 68
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      pub: Elsevier B.V.
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        2009634897
        10.1016/j.curtheres.2007.06.001
        105880497
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        atl: Prevalence of Helicobacter pylori in symptomatic patients and detection of clarithromycin resistance using melting curve analysis.
      aug:
        au:
          Kaya AD
          Öztürk CE
          Akcan Y
          Behçet M
          Karakoç AE
          Yücel M
          Misirlioglu M
          Tuncer S
        affil: Department of Microbiology, Duzce University, Medical Faculty Hospital, Konuralp/Duzce, 81620, Turkey; ademetkaya@superonline.com
      sug:
        subj:
          Clarithromycin Pharmacodynamics
          Drug Resistance, Microbial
          Helicobacter Infections Epidemiology
          Helicobacter Infections Symptoms
          Adolescence
          Adult
          Aged
          Female
          Funding Source
          Male
          Microbial Culture and Sensitivity Tests
          Middle Age
          Polymerase Chain Reaction Methods
          Sensitivity and Specificity
          Turkiye
          Human
          Adolescent: 13-18 years
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background:Clarithromycin is often a component of combination therapies for Helicobacter pylori eradication; however, increases in resistance rates have decreased the success of the treatment.Objective:This study was designed to determine the prevalence of H pylori infection in symptomatic patients and to detect clarithromycin resistance rates using melting curve analysis.Methods:Patients scheduled for upper endoscopy at the Endoscopy Unit of the Department of Gastroenterology, Duzce University, Medical Faculty Hospital, Konuralp/Duzce, Turkey, were assessed for enrollment in the study. Two pairs of gastric biopsy specimens (antrum and corpus) were obtained from each study patient. Histopathologic examination, rapid urease test, culture, and polymerase chain reaction (PCR) of the specimens were used to identify H pylori infection. Clarithromycin resistance was detected using melting curve analysis.Results:Seventy-five patients (41 women, 34 men; mean [SD]age, 42.6 [14.5] years [range, 17-70 years]) were included in the study. Using histopathology and rapid urease test, H pylori was detected in 40 (53.3%) of the 75 specimens. H pylori was detected using PCR in 40 (53.3%) specimens and by culture in 10 (13.3%) specimens. The specificity and sensitivity of PCR and culture were interpreted by comparing them with the results of histopathologic examination and urease tests. The specificity and sensitivity of PCR were 68.6% and 72.5%, respectively, and the specificity and sensitivity of culture were 97.1% and 22.5%, respectively. Of the 40 isolates, 21 (52.5%) were susceptible to clarithromycin, 12 (30.0%) were resistant, and a mixed susceptibility pattern was detected in 7 (17.5%) specimens. H pylori isolates from 19 (79.2%) of the 24 patients who had formerly used clarithromycin showed clarithromycin resistance.Conclusions:The prevalence of H pylori infection was 53.3% for the symptomatic patients in this study, and 47.5% of the isolates showed clarithromycin resistance using melting curve analysis. The PCR-based system used in this study was accurate for the detection of H pylori infection as well as clarithromycin susceptibility testing directly in biopsy specimens.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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