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Author Spotlight: Detection and Treatment of Helicobacter pylori Infection
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Helicobacter pylori is not eradicated after triple therapy: a nested PCR based study
Saurabh Kumar Patel1, Girish Narayan Mishra2, Chandra Bhan Pratap1
1Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India.
Biomed Research International
|July 24, 2014
Summary
Helicobacter pylori (H. pylori) may not be fully eradicated after triple therapy, as nested PCR detected its presence post-treatment. This sensitive method is more effective than traditional tests for H. pylori detection.
Area of Science:
- Medical Microbiology
- Gastroenterology
- Infectious Diseases
Background:
- Standard detection methods for Helicobacter pylori (H. pylori) post-treatment include rapid urease test (RUT), urea breath test (UBT), histology, culture, PCR, and serology.
- Assessing H. pylori eradication after triple therapy is crucial for patient outcomes and antimicrobial stewardship.
Purpose of the Study:
- To evaluate the efficacy of nested PCR in detecting H. pylori in antral biopsy specimens after triple therapy.
- To compare the sensitivity of nested PCR against RUT, culture, and histology for post-treatment H. pylori detection.
- To investigate potential genetic variations in H. pylori post-treatment.
Main Methods:
- Antral biopsy specimens from 25 patients were analyzed using RUT, culture, histology, and nested PCR before and after H. pylori triple therapy.
- Nested PCR targeted three H. pylori genes: hsp60, ureC, and fliI.
- Genetic analysis included restriction fragment length polymorphism (RFLP) and sequencing of specific amplicons.
Main Results:
- Post-treatment positivity rates decreased significantly for RUT (81.8% to 12%), culture (31% to 0%), histology (100% to 84%), and nested PCR (100% to 92%).
- Nested PCR demonstrated higher sensitivity in detecting H. pylori after therapy compared to RUT, culture, and histology.
- Genetic analysis revealed conserved hsp60 gene patterns but identified variations in fliI and ureC genes post-treatment, confirmed by sequencing.
Conclusions:
- Nested PCR is a more sensitive method for detecting H. pylori after triple therapy than conventional methods.
- The study suggests that H. pylori may not be completely eradicated in all patients following standard triple therapy.
- Observed genetic variations in H. pylori post-treatment warrant further investigation into treatment resistance mechanisms.
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