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Helicobacter pylori clarithromycin resistance detected by Etest and TaqMan real‐time polymerase chain reaction: a comparative study

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The aim of the work was to compare H. pylori clarithromycin‐resistance according two methods. Etest was performed on H. pylori isolated from gastric biopsy samples. TaqMan Real‐Time‐PCR (RT‐PCR) was performed on paraffin‐embedded gastric biopsy samples of the same patients. Forty‐seven out of 88 strains were resistant to clarithromycin by Etest, whereas RTPCR detected this resistance on paraffin‐embedded specimens of 50 patients. RTPCR performed on paraffin‐embedded biopsy specimens of 47 patients infected with H. pylori resistant to clarithromycin as detected by Etest, revealed the presence of a resistant strain only in 40 samples. RTPCR performed on samples of 41 patients harbouring clarithromycin‐susceptible H. pylori strains showed the presence of 31 susceptible and 10 resistant strains. RTPCR detected 18 cases with heteroresistant status. The difference between the two tests in detecting clarithromycin‐resistance was not statistically significant even if RTPCR detected more resistant cases. The genotyping resistance on paraffin‐embedded gastric biopsy specimens may be used to establish resistance to clarithromycin before the treatment when culture and susceptibility testing are not available. In case of failure of an empirical clarithromycin‐based triple antimicrobial treatment, RTPCR performed on paraffin‐embedded biopsy sample will establish the primary resistance to clarithromycin. In addition, this test can be useful for epidemiological investigation as well as for monitoring the evolution of clarithromycin resistance along the time.
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Document Type: Research Article

Publication date: 2012-09-01

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