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Updated: Jun 17, 2026
Detection of Helicobacter pylori Infection and Antibiotic Resistance via Stool Quantitative Polymerase Chain Reaction Analysis
Published on: May 16, 2025
Stool polymerase chain reaction for Helicobacter pylori detection and clarithromycin susceptibility testing in
Andreas Vécsei1, Albina Innerhofer, Christa Binder
1St. Anna Children's Hospital, Vienna, Austria.
Insights
Stool polymerase chain reaction (PCR) accurately detects Helicobacter pylori and its clarithromycin resistance in children. This noninvasive test is reliable for pediatric patients, especially with high resistance rates.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Helicobacter pylori infection is common in children.
- Clarithromycin resistance in H. pylori poses treatment challenges.
- Noninvasive diagnostic methods are needed for pediatric H. pylori detection.
Purpose of the Study:
- To evaluate a real-time polymerase chain reaction (PCR) assay for H. pylori detection.
- To assess the utility of stool PCR for clarithromycin susceptibility testing.
- To determine the reliability of noninvasive stool PCR in a pediatric population.
Main Methods:
- Retrospective analysis of pediatric patients undergoing gastroscopy.
- Stool specimens were analyzed using real-time PCR.
- Comparison with reference methods: rapid urease test, histology, and E-test for susceptibility.
Main Results:
- The stool PCR demonstrated high accuracy for H. pylori detection (90.2%).
- Sensitivity and specificity for H. pylori detection were 83.8% and 98.4%.
- High accuracy (94.0%) was observed for detecting clarithromycin resistance, with 89.2% sensitivity and 100% specificity.
Conclusions:
- Stool PCR is a reliable noninvasive tool for diagnosing H. pylori infection in children.
- The assay is effective for simultaneous detection and clarithromycin resistance testing.
- This method is particularly valuable in pediatric populations with high rates of clarithromycin-resistant H. pylori strains.
Background & Aims:
This study was undertaken in a pediatric gastroenterology clinic to retrospectively evaluate a real-time polymerase chain reaction (PCR) for the detection and clarithromycin susceptibility testing of Helicobacter pylori using stool specimens.
Methods:
All consecutive children who underwent a gastroscopy between March 2006 and February 2009 and also having been examined by stool PCR were enrolled. Rapid urease test, histology, and culture were the reference methods for the detection of H pylori and E-test for susceptibility testing, respectively.
Results:
A total of 143 children (mean age, 10.8 y; range, 2.8-17.9; males:females, 1:1.5) were evaluable. Sensitivity, specificity, and test accuracy for the detection of H pylori were 83.8%, 98.4%, and 90.2%, respectively. Sensitivity, specificity, and accuracy for the detection of clarithromycin resistance were 89.2%, 100%, and 94.0%, respectively.
Conclusions:
Stool PCR was a reliable and useful noninvasive tool for detection and clarithromycin susceptibility testing of H pylori in a pediatric population with a high prevalence of clarithromycin-resistant strains.
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