实时评估H. pylori感染以指导分子抗生素耐药性测试:一种结合内镜-胃汁分析方法
Riccardo Vasapolli1,2, Florent Ailloud2,3,4, Beate Spießberger3,4
1Department of Medicine II, University Hospital LMU Munich, Munich, Germany.
Alimentary pharmacology & therapeutics
|November 12, 2024
概括
从胃吸附物中进行的基因型抗生素敏感性测试 (G-AST) 可以准确检测Helicobacter pylori对克拉里素和勒沃素的耐药性. 这种新的方法有助于定制有效的H. pylori根除方案.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 分子诊断学 分子诊断
背景情况:
- 杆菌的抗生素耐药性是治疗失败的主要原因.
- 抗生素敏感性测试 (AST) 对于选择有效的H. pylori根除方案至关重要.
研究的目的:
- 评估基于胃吸附剂的基因型AST (G-AST) 诊断准确度,以检测克拉里素和勒沃素的耐药性.
- 将G-AST与传统的表型AST (P-AST) 进行比较.
主要方法:
- 招募了461名接受内镜检查的患者.
- 检测到H. pylori在程序内使用一种新的基于内镜的方法 (Endofaster) 与胃汁分析.
- 通过桑格测序对吸附DNA进行G-AST,使用ETEST对活检分离物进行P-AST.
主要成果:
- 在40.4%的患者中检测到H. pylori.
- 型耐药率为15.1%的克拉里思罗米辛和18.4%的勒沃素.
- G-AST与P-AST具有很高的一致性 (克拉胺素0.86卡帕,勒沃素0.81卡帕) 和高的诊断准确性 (97%和95%).
结论:
- 结合内镜与手术内胃汁分析和AST的新方法是适用于定制H. pylori根除的有效方法.
- 来自胃吸附物的基因型AST提供了高准确度检测克拉里胺和勒沃素耐药性.
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