Clarithromycin-resistant Helicobacter pylori in Ankara, Turkey: Detection by real-time PCR in formalin-fixed paraffin-embedded gastric biopsy samples.

Abstract

Choosing the appropriate treatment regimen for Helicobacter pylori (Hp) depends on knowing or predicting regional antibiotic resistance rates. In this study, we aimed to determine the frequency of Hp and clarithromycin (Cla) resistance rates by PCR analysis in formalin-fixed paraffin-embedded (FFPE) gastric biopsies of patients diagnosed with gastritis. Hp DNA and Hp Cla resistance (ClaR) were analyzed by PCR method. Diagnostic examination of gastric biopsy samples was evaluated according to the Updated Sydney System. Hp positivity was detected in 68 of 149 samples (45.6%). ClaR was detected in 29 Hp-positive samples (42.6%). A decrease in the resistance rate to Cla in HP was observed with increasing age (p = 0.08). The risk of resistance was higher in women (OR 1.1, 95% CI: 0.41-2.90, p = 0.86). The ClaR was higher in the 18-40 age group than in the over-60 age group (OR 5.5, 95% CI: 1.16-26.14, p = 0.03). The ClaR rate was found to be 42.6% by molecular method, indicating that classical triple therapy containing Cla is not a suitable option. Since resistance may vary according to geographical regions and years, regional studies with large populations are needed to determine antibiotic resistance rates before treatment planning.