Real-world Based Clinical Observation of Fecal Helicobacter pylori Drug Resistance Gene Detection Technology for Personalized Treatment Guidance
10.3969/j.issn.1008-7125.2024.12.002
- VernacularTitle:基于真实世界的粪便幽门螺杆菌耐药基因检测技术指导个体化治疗的临床观察
- Author:
Haocheng WANG
1
;
Ruolin PENG
1
;
Xiujuan WANG
1
;
Zhenyu ZHANG
1
Author Information
1. 南京医科大学附属南京医院(南京市第一医院)消化内科(210006)
- Publication Type:Journal Article
- Keywords:
Helicobacter pylori;
Drug-Resistant;
Gene Detection;
Eradication Therapy
- From:
Chinese Journal of Gastroenterology
2024;29(12):711-716
- CountryChina
- Language:Chinese
-
Abstract:
Background:Helicobacter pylori(Hp)drug resistance rate is increasing,rapid Hp drug resistance genotypic testing technology has become the focus of today's research,but its current clinical application is still very limited.Aims:To investigate the antibiotic resistance of Hp in Nanjing through the use of fecal Hp drug resistance gene testing.Additionally,the eradication effect of personalized Hp treatment guided by this technique was evaluated.Methods:The study included patients who underwent fecal Hp resistance gene testing at six hospitals in Nanjing between September 2022 and September 2024.Clarithromycin and levofloxacin resistance were obtained from the stool samples by detecting the presence of mutations in clarithromycin-associated resistance gene 23S rRNA and levofloxacin-associated resistance gene gyrA.In light of the test results,the patients were instructed to accept personalized eradication treatment for Hp.To this end,the patient's medical record was searched to obtain the treatment plan and review results.All participants signed an informed consent form.Results:A total of 780 patients with positive fecal Hp gene test were included in this study,and a total of 736 records of 23S rRNA/gyrA genotype testing were collected.The resistance rate of clarithromycin,levofloxacin and dual resistance was 51.36%,37.77%and 30.84%,respectively.These findings were statistically significant(P<0.001).The overall eradication rate of Hp was 90.06%(299/332).The eradication rate of the bismuth quadruple regimen of amoxicillin and furazolidone,the bismuth quadruple regimen of amoxicillin and clarithromycin,the bismuth quadruple regimen of amoxicillin and doxycycline,the bismuth quadruple regimen of amoxicillin and levofloxacin,the bismuth quadruple regimen of furazolidone and doxycycline was 92.39%,89.66%,91.43%,73.33%and 77.78%,respectively.The difference in Hp eradication rates for treatment regimens using different combinations of antibiotics was statistically significant(P=0.045).Conclusions:The prevalence of resistance to clarithromycin and levofloxacin among Hp strains in Nanjing has reached a high level.The fecal Hp resistance gene test has achieved satisfactory results in guiding the eradication of Hp,with an overall eradication rate of more than 90%,and deserves to be widely used in the clinical eradication of Hp.
