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Related Concept Videos

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Updated: Jan 16, 2026

Author Spotlight: Detection and Treatment of Helicobacter pylori Infection
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Droplet Digital PCR-Based Detection of Clarithromycin Resistance on Rapid Urease Test Samples Predicts Helicobacter

Stephen James Inns1,2, Samantha Sowerbutts1, Bibek Yumnam3

  • 1University of Otago, Wellington, New Zealand.

Helicobacter
|September 27, 2025
PubMed
Summary

Clarithromycin resistance in Helicobacter pylori significantly lowers eradication rates in New Zealand. Detecting resistance genes using droplet digital PCR on Rapid Urease Test samples is feasible and guides tailored therapy for better outcomes.

Keywords:
Helicobacter pyloriclarithromycin resistancetailored therapy

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Area of Science:

  • Medical Diagnostics
  • Microbiology
  • Gastroenterology

Background:

  • Helicobacter pylori infection causes peptic ulcers and gastric cancer.
  • Rising clarithromycin resistance reduces standard triple therapy effectiveness.
  • Antibiotic resistance impact in Aotearoa New Zealand needs further definition.

Purpose of the Study:

  • Evaluate droplet digital PCR (ddPCR) feasibility for detecting clarithromycin resistance genes in H. pylori.
  • Assess the clinical utility of ddPCR on stored Rapid Urease Test (RUT) samples.
  • Correlate resistance status with treatment outcomes after empiric triple therapy.

Main Methods:

  • Collected stored Rapid Urease Test samples from H. pylori-positive patients.
  • Utilized ddPCR to detect clarithromycin resistance genes.
  • Administered omeprazole-based triple therapy and confirmed eradication via stool antigen testing.

Main Results:

  • Clarithromycin resistance genes detected in 15.5% of 84 patients.
  • Eradication success was significantly lower in resistant cases (38.5%) vs. non-resistant (97.2%).
  • Resistance status, not infection burden or treatment details, was the primary determinant of treatment failure.

Conclusions:

  • ddPCR on stored RUT samples is a viable method for clarithromycin resistance detection.
  • Clarithromycin resistance is the key driver of eradication failure in New Zealand.
  • Molecular resistance testing can personalize therapy, improve success rates, and support antibiotic stewardship.