Screening for Helicobacter pylori infection and Clarithromycin resistance using Real-Time Polymerase Chain Reaction

Area of Science:

• Gastroenterology
• Infectious Diseases
• Molecular Diagnostics

Background:

• Helicobacter pylori infection affects half the global population, increasing gastric cancer risk.
• Dyspeptic symptoms are common, necessitating accurate H. pylori diagnostics.
• Antibiotic resistance, particularly to Clarithromycin, complicates H. pylori eradication.

Purpose of the Study:

• To screen patients with dyspeptic symptoms for H. pylori infection.
• To determine the prevalence of Clarithromycin resistance in infected individuals.
• To evaluate a molecular diagnostic approach for H. pylori and its resistance.

Main Methods:

• Real-Time Polymerase Chain Reaction (RT-PCR) on stool samples for H. pylori detection.
• RNA-DNA extraction followed by molecular testing.
• Detection of point mutations in the 23S rRNA gene for Clarithromycin resistance assessment.
• Confirmation of positive results using breath and stool antigen tests.

Main Results:

• H. pylori infection was identified in 48% of 50 patients using RT-PCR.
• Clarithromycin resistance was found in 29.17% of infected patients.
• The molecular test demonstrated high accuracy (92%), sensitivity (85.71%), and specificity (100%).
• Infected patients reported gastrointestinal symptoms more frequently.

Conclusions:

• Molecular stool testing is a highly accurate method for H. pylori screening.
• Simultaneous assessment of Clarithromycin resistance improves H. pylori eradication therapy.
• This diagnostic strategy can enhance patient outcomes by guiding treatment decisions.