实时荧光定量PCR幽门螺杆菌检测与克拉霉素耐药性鉴定的比较:一项单中心现实研究

IF 4.3 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Helicobacter Pub Date : 2025-04-07 DOI:10.1111/hel.70031
Kateryna Priadko, Sophie-Anne Gibaud, Amaury Druet, Louise Galmiche, Francis Megraud, Stéphane Corvec, Tamara Matysiak-Budnik
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引用次数: 0

摘要

在本中心,由于RT-PCR在COVID-19大流行后具有较高的可用性,因此将其作为诊断幽门螺杆菌的常规方法。本研究的目的是评估在现实临床实践中系统地进行RT-PCR检测幽门螺杆菌和克拉霉素(CLA)耐药性的可行性和性能。材料和方法连续100例患者接受了上消化道内窥镜检查,期间至少进行了4次活检(2次来自上颌窦,2次来自上颌体),用于RT-PCR和抗生素培养,另外进行了4次组织学活检。比较RT-PCR、组织学和细菌培养的幽门螺杆菌检测结果,并比较基于培养的抗生素谱和RT-PCR的CLA敏感性结果。结果100例患者中,RT-PCR阳性64例,组织学阳性66例,培养阳性53例,3种方法比较差异无统计学意义(p > 0.05)。45例患者中有8例(17.7%)对CLA耐药,64例患者中有12例(18.7%)对CLA耐药。在8例幽门螺旋杆菌培养阳性患者中,由于菌株缺乏生存能力,抗生素谱无法实现。在一名患者中,经过双重检查,观察到不同的结果,需要法国国家幽门螺杆菌参考中心进行补充分子分析,该中心证实了活组织检查中存在双重幽门螺杆菌菌株,有无CLA耐药。结论我们的研究表明,在实际的临床实践中,RT-PCR检测幽门螺杆菌及其对CLA的耐药性的能力具有可行性和可比性。考虑到它的快速和对操作员解释的有限依赖,它似乎比其他方法更可取。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Real-Time PCR Helicobacter pylori Test in Comparison With Culture and Histology for Helicobacter pylori Detection and Identification of Resistance to Clarithromycin: A Single-Center Real-Life Study

Real-Time PCR Helicobacter pylori Test in Comparison With Culture and Histology for Helicobacter pylori Detection and Identification of Resistance to Clarithromycin: A Single-Center Real-Life Study

Background

In our center, RT-PCR was integrated as a routine method to diagnose Helicobacter pylori due to its higher availability after COVID-19 pandemics. The objective of this study was to assess the feasibility and performance of systematically performed RT-PCR for H. pylori detection and clarithromycin (CLA) resistance in a real-life clinical practice.

Materials and Methods

One hundred consecutive patients underwent an upper digestive endoscopy during which at least four biopsies (two from the antrum and two from the corpus) were obtained for RT-PCR and culture with antibiogram and four additional biopsies for histology. The results of H. pylori detection were compared among RT-PCR, histology, and bacterial culture, and the results of CLA susceptibility were compared between culture-based antibiogram and RT-PCR.

Results

Out of 100 patients, 64 were positive for H. pylori by RT-PCR, 66 by histology, and 53 by culture, with no statistically significant difference among the three methods (p > 0.05). CLA resistance was found in 8 out of 45 patients (17.7%) by culture and in 12 out of 64 patients (18.7%) by PCR. In 8 H. pylori-positive patients by culture, the antibiogram could not be realized due to lack of viability of the strains. In one patient, after a double checking, discrepant results were observed, requiring a complementary molecular analysis by the French National Reference Center for Helicobacters, which confirmed the existence of a double population of H. pylori strains within biopsies, with and without CLA resistance.

Conclusions

Our study demonstrates that in real-life clinical practice, RT-PCR is feasible and comparable in the ability to detect H. pylori and its resistance to CLA to bacterial culture with antibiogram and histology. Given its rapidity and limited dependence on the operator's interpretation, it appears preferable to the other methods.

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来源期刊
Helicobacter
Helicobacter 医学-微生物学
CiteScore
8.40
自引率
9.10%
发文量
76
审稿时长
2 months
期刊介绍: Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.
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