Multiple Genetic Analysis System-Based Antibiotic Susceptibility Testing in Helicobacter pylori and High Eradication Rate With Phenotypic Resistance-Guided Quadruple Therapy.
Antibiotics resistance in Helicobacter pylori (H. pylori) is the major factor for eradication failure. Molecular tests including fluorescence in situ hybridization, PCR-restriction fragment length polymorphism, and dual priming oligonucleotide-PCR (DPO-PCR) play critical roles in the detection of an...
| Publicado en: | Medicine Vol. 94; no. 47; pp. 1 - 8 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Nov2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=112831995&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 112831995 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00257974 2S6 jtl: Medicine issn: 00257974 maglogo: N pubinfo: dt: Nov2015 vid: 94 iid: 47 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 112831995 112831995 NLM26632710 112831995 10.1097/MD.0000000000002056 NLM26632710 112831995 ppf: 1 ppct: 7 formats: tig: atl: Multiple Genetic Analysis System-Based Antibiotic Susceptibility Testing in Helicobacter pylori and High Eradication Rate With Phenotypic Resistance-Guided Quadruple Therapy. aug: au: Fangyuan Dong Danian Ji Renxiang Huang Fan Zhang Yiqin Huang Ping Xiang Mimi Kong Li Nan Xianping Zeng Yong Wu Zhijun Bao Dong, Fangyuan Ji, Danian Huang, Renxiang Zhang, Fan Huang, Yiqin Xiang, Ping Kong, Mimi Nan, Li Zeng, Xianping affil: Department of Gastroenterology, Shanghai Key Laboratory of Clinical Geriatric Medicine sug: subj: Drug Resistance, Microbial Helicobacter Pylori Drug Effects Dyspepsia Drug Therapy Antibiotics Pharmacodynamics Dyspepsia Microbiology Helicobacter Pylori Helicobacter Infections Diagnosis Genome Antibiotics Classification Helicobacter Infections Drug Therapy Dyspepsia Diagnosis Helicobacter Infections Microbiology Male Drug Therapy, Combination Methods Microbial Culture and Sensitivity Tests Methods Sensitivity and Specificity Human Adult Middle Age Treatment Outcomes Drug Monitoring Female Breath Tests Methods Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Antibiotics resistance in Helicobacter pylori (H. pylori) is the major factor for eradication failure. Molecular tests including fluorescence in situ hybridization, PCR-restriction fragment length polymorphism, and dual priming oligonucleotide-PCR (DPO-PCR) play critical roles in the detection of antibiotic susceptibility; however, limited knowledge is known about application of multiple genetic analysis system (MGAS) in the area of H. pylori identification and antibiotics resistance detection.The aim of this study is to determine the antibiotics resistance using different molecular tests and evaluate the treatment outcomes of E-test-based genotypic resistance.A total of 297 patients with dyspepsia complaint were recruited for gastroscopies. Ninety patients with H. pylori culture positive were randomly divided into 2 groups (test group and control group). E-test, general PCR, and MGAS assay were performed in test group. Patients in control group were treated with empirical therapy (rabeprazole + bismuth potassium citrate + amoxicillin [AMX] + clarithromycin [CLR]), whereas patients in test group received quadruple therapy based on E-test results twice daily for 14 consecutive days. The eradication effect of H. pylori was confirmed by C-urea breath test after at least 4 weeks when treatment was finished.Rapid urease test showed 46.5% (128/297) patients with H. pylori infection, whereas 30.3% (90/297) patients were H. pylori culture positive. E-test showed that H. pylori primary resistance rate to CLR, AMX, metronidazole, tetracycline, and levofloxacin (LVX) was 40.0% (18/45), 4.4% (2/45), 53.3% (24/45), 0% (0/45), and 55.6% (25/45), respectively. In addition, there are many multidrug resistant (MDR) phenotypes, and the MDR strains have higher minimum inhibitory concentration than their single-drug resistant counterparts. Considering E-test as the reference test, the sensitivities of general PCR and MGAS in detecting CLR resistance were 83.3% (15/18) and 94.4% (17/18), whereas in detecting LVX resistance were 100% (25/25) and 83.3% (15/18), respectively. Finally, the eradication rate in test group was significantly higher than that in control group as demonstrated by intention-to-treat analysis and per-protocol analysis.MGAS is a promising assay for H. pylori identification and antibiotic susceptibility testing. Phenotypic resistance-guided quadruple therapy showed a high efficacy in treating patients with H. pylori infection. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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