Si Yu-Ting, Xiong Xue-Song, Zhang Shen-Ke, Lai Jin-Xin, Li Yu-Ting, Umar Zeeshan, Luan Luan, Tang Jia-Wei, Li Zheng-Kang, Li Fen, Gu Bing, Wang Liang
Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China.
Huai'an Hospital Affiliate to Yangzhou University (The Fifth People's Hospital of Huai'an), Huai'an, Jiangsu Province, China.
J Gastroenterol Hepatol. 2025 Jul;40(7):1763-1771. doi: 10.1111/jgh.16962. Epub 2025 Apr 2.
Helicobacter pylori (H. pylori) infection has long been a significant global public health concern, with antibiotic resistance becoming increasingly severe. Gastric fluid qPCR detection can provide information on H. pylori infection and antibiotic resistance.
This study compares a series of diagnostic methods among 300 participants to reveal best practices for detecting H. pylori infection and/or profiling antibiotic resistance, including urea breath test (UBT), rapid urease test (RUT), gastric mucosa qPCR (GM-qPCR), and the novel gastric fluid qPCR (GF-qPCR).
The infection rates detected by UBT and RUT were 32.33% and 23.33%, respectively. Through qPCR analysis, the infection rates in gastric fluid and gastric mucosal were 27.67% and 25.33%. When comparing three methods of detecting H. pylori using the UBT as the reference standard, it was found that the sensitivity, specificity, positive and negative predictive values, and accuracy of gastric fluid qPCR performed the best. The consistency of the four methods was assessed using the Kappa value, which yielded a value of 0.792. Additionally, 45 individuals showed inconsistent results. When using qPCR to detect antibiotic resistance in gastric fluid and gastric mucosal samples, we observed resistance rates of 42.17% (35/83) for clarithromycin and 49.40% (41/83) for levofloxacin in gastric fluid samples. In contrast, resistance rates in gastric mucosal tissue samples were significantly lower at 16.87% (14/76) for clarithromycin and 22.37% (17/76) for levofloxacin.
The GF-qPCR method is a promising technique for detecting H. pylori infection and antibiotic resistance, with the potential for providing guided treatment plans.
幽门螺杆菌（H. pylori）感染长期以来一直是全球重大的公共卫生问题，抗生素耐药性日益严重。胃液定量聚合酶链反应（qPCR）检测可为幽门螺杆菌感染及抗生素耐药性提供信息。
本研究比较了300名参与者的一系列诊断方法，以揭示检测幽门螺杆菌感染和/或分析抗生素耐药性的最佳方法，包括尿素呼气试验（UBT）、快速尿素酶试验（RUT）、胃黏膜qPCR（GM-qPCR）和新型胃液qPCR（GF-qPCR）。
UBT和RUT检测的感染率分别为32.33%和23.33%。通过qPCR分析，胃液和胃黏膜中的感染率分别为27.67%和25.33%。以UBT作为参考标准比较三种检测幽门螺杆菌的方法时，发现胃液qPCR的敏感性、特异性、阳性和阴性预测值及准确性表现最佳。使用Kappa值评估这四种方法的一致性，结果为0.792。此外，45人结果不一致。当使用qPCR检测胃液和胃黏膜样本中的抗生素耐药性时，我们观察到胃液样本中克拉霉素的耐药率为[42.17%（35/83）]，左氧氟沙星的耐药率为[49.40%（41/83）]。相比之下，胃黏膜组织样本中克拉霉素的耐药率显著较低，为[16.87%（14/76）]，左氧氟沙星的耐药率为[22.37%（17/76）]。
GF-qPCR方法是一种用于检测幽门螺杆菌感染和抗生素耐药性的有前景的技术，具有提供指导性治疗方案的潜力。
