Department of Gastroenterology, University Hospital "Tsaritsa Ioanna-ISUL", Medical University of Sofia, Bulgaria.
Eur Rev Med Pharmacol Sci. 2021 Aug;25(15):5042-5046. doi: 10.26355/eurrev_202108_26461.
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.
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).
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%.
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.
幽门螺杆菌（H. pylori）感染在全球范围内广泛传播，影响了至少一半的世界人口。受感染的人患多种疾病的风险增加，包括胃腺癌。本研究旨在筛查有消化不良症状的患者是否存在 H. pylori 感染，并评估感染患者中克拉霉素耐药的流行情况。
对所有患者进行 H. pylori 感染筛查，采用基于粪便 RNA-DNA 提取的实时聚合酶链反应（RT-PCR）的分子检测。所有参与者的粪便样本均在患者住院后 1 至 3 天采集。阳性结果进一步通过呼气试验和粪便抗原试验进行确认。通过 23S rRNA 基因的点突变检测可以检测克拉霉素耐药性。统计分析采用 SPSS 22.0（IBM 公司，纽约州阿蒙克）进行。
本研究纳入了 50 名患者（18 名男性），平均年龄为 46.46±15.10 岁。我们使用基于粪便的 RT-PCR 分子检测鉴定出 24 名患者（48.00%）存在 H. pylori 感染。其中 7 名（29.17%）患者存在克拉霉素耐药。这些患者均未接受过先前的根除治疗。感染和非感染患者在年龄和性别方面无显著差异。感染患者更常报告胃肠道症状（p<0.05）。分子检测的敏感性为 85.71%，特异性为 100%，诊断准确性为 92.00%。
基于粪便的 RT-PCR 分子检测筛查 H. pylori 可能是有益的，因为该检测的准确性高，包括克拉霉素耐药性评估，可以改善根除治疗的效果。
