Screening for Helicobacter pylori infection and Clarithromycin resistance using Real-Time Polymerase Chain Reaction

M. Kovacheva-Slavova, H. Valkov, T. Angelov, R. Tropcheva, B. Vladimirov

Department of Gastroenterology, University Hospital “Tsaritsa Ioanna-ISUL”, Medical University of Sofia, Bulgaria. kovacheva_mila@abv.bg

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• Gastroenterology
• Infectious Diseases

OBJECTIVE: Helicobacter pylori (H. pylori) infection is spread worldwide and affects at least half of the world’s population. Infected people are at increased risk of several diseases’ development, including gastric adenocarcinoma. The aim of this study was to screen patients with dyspeptic symptoms for H. pylori infection and assess Clarithromycin resistance prevalence among the infected patients.

PATIENTS AND METHODS: Screening for H. pylori infection was performed in all patients using molecular test based on Real-Time Polymerase Chain Reaction (RT-PCR) in feces after RNA-DNA extraction. Stool samples from all participants were collected 1 to 3 days after patients’ hospitalization. The positive results were furthermore assessed for confirmation by breath test and stool antigen test. By point mutations detection in 23S rRNA gene was possible to detect Clarithromycin resistance. Statistical analysis was performed via SPSS 22.0 (IBM Corp., Armonk, NY, USA).

RESULTS: This study enrolled 50 patients (18 males) at mean age 46.46±15.10 years. Using molecular test based on RT-PCR in feces we identified H. pylori infection in 24 patients (48.00%). Clarithromycin resistance was observed in 7 of them (29.17%). None of those patients was eradicated before. There was no significant difference by age and gender between infected and non-infected patients. Gastrointestinal symptoms were more often reported in infected patients (p<0.05). The molecular test showed 85.71% sensitivity and 100% specificity, with a diagnostic accuracy of 92.00%.

CONCLUSIONS: H. pylori screening by molecular test based on RT-PCR in feces might be beneficial as the test’s accuracy is high and include Clarithromycin resistance assessment, which could improve the outcome of eradication therapy.

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