[Detection of Helicobacter pylori 23S rRNA gene mutation associated with clarithromycin resistance and its clinical applicability].

Clarithromycin is one of the most important antibiotics for H. pylori eradication. However, 5-10% was reported to be resistant. It has been shown that one point mutation in the 23S rRNA gene is associated with resistance to clarithromycin. We confirmed that this finding applied to the isolates in Japan. To detect H. pylori infection and the mutation simultaneously, we have designed PCR primers specific for H. pylori, and established assays of PCR-RFLP and PCR-preferential homo-duplex formation (PHFA). Compared with other conventional methods, these assays achieved above 95% sensitivity. It is also demonstrated that the eradication rates achieved by clarithromycin-based regimens significantly differed between mutant and wild type infections. By detecting of 23S rRNA gene mutations associated with clarithromycin resistance, patients can be treated with adequate antibiotics with information about resistance.