French National Reference Centre for Campylobacters & Helicobacters, Hôpital Pellegrin, Bordeaux, France.
INSERM, UMR1053 Bordeaux BaRITOn, University Bordeaux, Bordeaux, France.
Helicobacter. 2018 Oct;23(5):e12512. doi: 10.1111/hel.12512. Epub 2018 Aug 28.
Knowledge of antimicrobial susceptibility, especially to macrolides, has become crucial for the management of Helicobacter pylori infection. Our aim was to evaluate two new PCR kits able to detect H. pylori in gastric biopsies as well as the mutations associated with macrolide resistance.
Two hundred successive biopsies (received from gastroenterologists all over France) were used. The two new kits tested were Amplidiag H. pylori+Clari from Mobidiag Espoo, Finland, and RIDA GENE H. pylori from R-Biopharm, Darmstadt, Germany. Culture and a validated in-house real-time PCR were also performed, and in the case of a positive culture, Etest for clarithromycin was carried out. Discrepancies were solved by looking at the pathologic data.
Culture was positive in 68 cases (34%), and with our in-house real-time PCR in these 68 cases plus 5 others (N = 73, 36%). All were also detected by the two new kits. In addition, RIDA GENE H. pylori detected one more positive also detected by Amplidiag H. pylori+Clari , and Amplidiag detected two other positives. Of these three additional cases, pathology confirmed the positivity for two. Only one case diagnosed by Amplidiag could be considered as a false positive. With regard to clarithromycin resistance, 22 cases were detected. The corresponding mutations (A2142/43G) were all identified with the three PCRs.
These two new kits which have an excellent sensitivity and specificity are convenient to use, adaptable to different thermocyclers, provide quick results, and deserve to be used in H. pylori diagnosis for a better choice of treatment regimen.
对抗生素敏感性的了解，尤其是大环内酯类药物的敏感性，对于幽门螺杆菌感染的治疗至关重要。我们的目的是评估两种新的 PCR 试剂盒，它们能够检测胃活检中的幽门螺杆菌以及与大环内酯类药物耐药相关的突变。
使用了 200 例连续的活检样本（来自法国各地的胃肠病学家）。测试的两种新试剂盒是来自芬兰 Mobidiag Espoo 的 Amplidiag H. pylori+Clari 和来自德国 R-Biopharm 的 RIDA GENE H. pylori。还进行了培养和经过验证的实时 PCR，并且在培养阳性的情况下，进行了克拉霉素的 Etest。通过查看病理数据解决了差异。
培养阳性 68 例（34%），而我们的内部实时 PCR 在这 68 例加 5 例（N=73，36%）中也是阳性。两种新试剂盒都能检测到所有这些。此外，RIDA GENE H. pylori 检测到另外一个 Amplidiag H. pylori+Clari 检测到的阳性，而 Amplidiag 检测到另外两个阳性。在这三个额外的病例中，病理学证实了两个病例为阳性。只有一个被 Amplidiag 诊断为阳性的病例可以被认为是假阳性。关于克拉霉素耐药性，检测到 22 例。所有这些病例的突变（A2142/43G）都与三种 PCR 方法一致。
这两种新试剂盒具有出色的灵敏度和特异性，使用方便，适用于不同的热循环仪，提供快速的结果，值得在幽门螺杆菌诊断中使用，以更好地选择治疗方案。
