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Updated: May 28, 2026

Quantitative Polymerase Chain Reaction (qPCR)-Based Rapid Diagnosis of Helicobacter pylori Infection and Antibiotic Resistance
Published on: July 28, 2023
Routine Susceptibility Testing of Helicobacter pylori in Clinical Practice-Results of a Prospective Multicentre Study
Anke Hildebrandt1,2, Farina Wewers1,2, Lutz Uflacker2
1Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany.
Implementing routine Helicobacter pylori (HP) susceptibility testing alongside urease tests is feasible. This approach enables resistance-oriented therapy and aids in monitoring regional HP resistance patterns for better antimicrobial stewardship.
Area of Science:
- Microbiology
- Clinical Medicine
- Pharmacology
Background:
- Current Helicobacter pylori (HP) eradication in Germany relies on empirical antibiotic therapy.
- National guidelines dictate treatment strategies without routine susceptibility testing.
- A need exists for localized resistance data to guide effective first-line treatments.
Purpose of the Study:
- To implement routine HP antibiotic susceptibility testing in clinical practice.
- To facilitate resistance-oriented first-line antibiotic therapy.
- To collect local and regional HP antibiotic resistance data.
Main Methods:
- Prospective multicentre study conducted in two German hospitals.
- Biopsies for Helicobacter urease test (HUT) and susceptibility testing were collected during gastroscopy.
- Phenotypic and genotypic resistance testing against key antibiotics (amoxicillin, clarithromycin, metronidazole, levofloxacin, rifampicin, tetracycline) were performed.
Main Results:
- Out of 1503 patients, 256 (17.0%) tested positive for HP.
- Susceptibility testing was performed on 311 positive HUT samples.
- Regional resistance varied: metronidazole (3-33%), clarithromycin (16-20%), and levofloxacin (13-16%).
Conclusions:
- HP antibiotic susceptibility testing is technically feasible using the same biopsy as HUT.
- This method can be applied in both hospital and outpatient endoscopic settings.
- Routine testing supports individualized therapy, regional resistance monitoring, and antimicrobial stewardship.
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