Ruolin Peng, Zhimei Zhang, Chuchu Yang, Zhengyuan Xu, Jiabin Wang, Lei Chen, Sujun Gao, Jian Tao, Meijuan Xi, Xiaofeng Ye, Lu Shen, Qiang Zhan, Lijia Din, Jun Wang, Rong Ou, Jianhua Cui, Lin Chen, Xiaodan Xu, Gongyu Zhang, Chunyan Xu, Jing Du, Guangxia Chen, Xinxin Zhao, Lamei Xu, Min Xu, Zhenyu Zhang
{"title":"粪便样本PCR检测指导幽门螺杆菌个性化治疗的临床评价：一项真实世界的研究。","authors":"Ruolin Peng, Zhimei Zhang, Chuchu Yang, Zhengyuan Xu, Jiabin Wang, Lei Chen, Sujun Gao, Jian Tao, Meijuan Xi, Xiaofeng Ye, Lu Shen, Qiang Zhan, Lijia Din, Jun Wang, Rong Ou, Jianhua Cui, Lin Chen, Xiaodan Xu, Gongyu Zhang, Chunyan Xu, Jing Du, Guangxia Chen, Xinxin Zhao, Lamei Xu, Min Xu, Zhenyu Zhang","doi":"10.3389/fcimb.2025.1519804","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Growing antibiotic resistance in <i>Helicobacter pylori</i> (<i>H. pylori</i>) diminishes eradication therapy effectiveness, emphasizing the need for accurate, non-invasive diagnostic techniques. This study aims to assess the clinical utility of PCR analysis of fecal samples for detecting antibiotic resistance in guiding personalized treatment for <i>H. pylori</i> infection.</p><p><strong>Methods: </strong>A retrospective, observational study was conducted across 13 hospitals within Jiangsu Province. Fecal samples were analyzed using fluorescence PCR for the <i>23S rRNA</i> and <i>gyrA</i> genes, indicating clarithromycin and levofloxacin resistance. Then, individualized eradication recommendations were proposed for the <i>H. pylori</i>-positive patients. A follow-up was performed one year later to evaluate the eradication outcomes in a routine medical environment, with participants having provided informed consent.</p><p><strong>Results: </strong>A total of 387 participants completed the eradication treatment, with an overall success rate of 91.0% (352/387, 95% CI: 87.6%-93.6%). Among them, 310 individuals received a 14-day course of bismuth quadruple therapy (BQT), achieving an eradication rate of 90.0% (279/310, 95% CI: 86.1%-93.1%). 77 participants were treated with high-dose dual therapy (HDDT) for the same duration, resulting in a slightly higher eradication rate of 94.8% (73/77, 95% CI: 87.2%-98.6%), although this difference was not statistically significant (<i>P</i>=0.188). No significant differences in eradication rates were observed among various BQT antibiotic combinations (<i>P</i>=0.208). The eradication rates for HDDT, based on either vonoprazan or esomeprazole, were 96.8% (61/63, 95% CI: 89.0%-99.6%) and 85.7% (12/14, 95% CI: 57.2%-98.2%), respectively, without a significant difference (<i>P</i>=0.304).</p><p><strong>Conclusion: </strong>PCR detection from fecal samples targeting the resistance genes of <i>H. pylori</i> is effective in guiding personalized treatments, highlighting its clinical utility and potential for broader application.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"15 ","pages":"1519804"},"PeriodicalIF":4.6000,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066622/pdf/","citationCount":"0","resultStr":"{\"title\":\"Clinical evaluation of personalized <i>Helicobacter pylori</i> treatment guided by PCR detection from fecal samples: a real-world study.\",\"authors\":\"Ruolin Peng, Zhimei Zhang, Chuchu Yang, Zhengyuan Xu, Jiabin Wang, Lei Chen, Sujun Gao, Jian Tao, Meijuan Xi, Xiaofeng Ye, Lu Shen, Qiang Zhan, Lijia Din, Jun Wang, Rong Ou, Jianhua Cui, Lin Chen, Xiaodan Xu, Gongyu Zhang, Chunyan Xu, Jing Du, Guangxia Chen, Xinxin Zhao, Lamei Xu, Min Xu, Zhenyu Zhang\",\"doi\":\"10.3389/fcimb.2025.1519804\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Growing antibiotic resistance in <i>Helicobacter pylori</i> (<i>H. pylori</i>) diminishes eradication therapy effectiveness, emphasizing the need for accurate, non-invasive diagnostic techniques. This study aims to assess the clinical utility of PCR analysis of fecal samples for detecting antibiotic resistance in guiding personalized treatment for <i>H. pylori</i> infection.</p><p><strong>Methods: </strong>A retrospective, observational study was conducted across 13 hospitals within Jiangsu Province. Fecal samples were analyzed using fluorescence PCR for the <i>23S rRNA</i> and <i>gyrA</i> genes, indicating clarithromycin and levofloxacin resistance. Then, individualized eradication recommendations were proposed for the <i>H. pylori</i>-positive patients. A follow-up was performed one year later to evaluate the eradication outcomes in a routine medical environment, with participants having provided informed consent.</p><p><strong>Results: </strong>A total of 387 participants completed the eradication treatment, with an overall success rate of 91.0% (352/387, 95% CI: 87.6%-93.6%). Among them, 310 individuals received a 14-day course of bismuth quadruple therapy (BQT), achieving an eradication rate of 90.0% (279/310, 95% CI: 86.1%-93.1%). 77 participants were treated with high-dose dual therapy (HDDT) for the same duration, resulting in a slightly higher eradication rate of 94.8% (73/77, 95% CI: 87.2%-98.6%), although this difference was not statistically significant (<i>P</i>=0.188). No significant differences in eradication rates were observed among various BQT antibiotic combinations (<i>P</i>=0.208). The eradication rates for HDDT, based on either vonoprazan or esomeprazole, were 96.8% (61/63, 95% CI: 89.0%-99.6%) and 85.7% (12/14, 95% CI: 57.2%-98.2%), respectively, without a significant difference (<i>P</i>=0.304).</p><p><strong>Conclusion: </strong>PCR detection from fecal samples targeting the resistance genes of <i>H. pylori</i> is effective in guiding personalized treatments, highlighting its clinical utility and potential for broader application.</p>\",\"PeriodicalId\":12458,\"journal\":{\"name\":\"Frontiers in Cellular and Infection Microbiology\",\"volume\":\"15 \",\"pages\":\"1519804\"},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2025-04-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066622/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Cellular and Infection Microbiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fcimb.2025.1519804\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Cellular and Infection Microbiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fcimb.2025.1519804","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Clinical evaluation of personalized Helicobacter pylori treatment guided by PCR detection from fecal samples: a real-world study.
Background: Growing antibiotic resistance in Helicobacter pylori (H. pylori) diminishes eradication therapy effectiveness, emphasizing the need for accurate, non-invasive diagnostic techniques. This study aims to assess the clinical utility of PCR analysis of fecal samples for detecting antibiotic resistance in guiding personalized treatment for H. pylori infection.
Methods: A retrospective, observational study was conducted across 13 hospitals within Jiangsu Province. Fecal samples were analyzed using fluorescence PCR for the 23S rRNA and gyrA genes, indicating clarithromycin and levofloxacin resistance. Then, individualized eradication recommendations were proposed for the H. pylori-positive patients. A follow-up was performed one year later to evaluate the eradication outcomes in a routine medical environment, with participants having provided informed consent.
Results: A total of 387 participants completed the eradication treatment, with an overall success rate of 91.0% (352/387, 95% CI: 87.6%-93.6%). Among them, 310 individuals received a 14-day course of bismuth quadruple therapy (BQT), achieving an eradication rate of 90.0% (279/310, 95% CI: 86.1%-93.1%). 77 participants were treated with high-dose dual therapy (HDDT) for the same duration, resulting in a slightly higher eradication rate of 94.8% (73/77, 95% CI: 87.2%-98.6%), although this difference was not statistically significant (P=0.188). No significant differences in eradication rates were observed among various BQT antibiotic combinations (P=0.208). The eradication rates for HDDT, based on either vonoprazan or esomeprazole, were 96.8% (61/63, 95% CI: 89.0%-99.6%) and 85.7% (12/14, 95% CI: 57.2%-98.2%), respectively, without a significant difference (P=0.304).
Conclusion: PCR detection from fecal samples targeting the resistance genes of H. pylori is effective in guiding personalized treatments, highlighting its clinical utility and potential for broader application.
期刊介绍：
Frontiers in Cellular and Infection Microbiology is a leading specialty journal, publishing rigorously peer-reviewed research across all pathogenic microorganisms and their interaction with their hosts. Chief Editor Yousef Abu Kwaik, University of Louisville is supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
Frontiers in Cellular and Infection Microbiology includes research on bacteria, fungi, parasites, viruses, endosymbionts, prions and all microbial pathogens as well as the microbiota and its effect on health and disease in various hosts. The research approaches include molecular microbiology, cellular microbiology, gene regulation, proteomics, signal transduction, pathogenic evolution, genomics, structural biology, and virulence factors as well as model hosts. Areas of research to counteract infectious agents by the host include the host innate and adaptive immune responses as well as metabolic restrictions to various pathogenic microorganisms, vaccine design and development against various pathogenic microorganisms, and the mechanisms of antibiotic resistance and its countermeasures.
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