目标:幽门螺杆菌(H.幽门螺杆菌)是一种全球流行的细菌,会增加患各种胃肠道疾病的风险,包括胃腺癌.本研究旨在评价实时荧光定量PCR检测幽门螺杆菌感染的性能,以及克拉霉素和左氧氟沙星的耐药性,在粪便和胃活检标本中。
方法:在住院后1至3天内收集患者的粪便和胃活检标本。使用基于实时PCR的分子测定法分析所有患者的幽门螺杆菌感染以及对克拉霉素和左氧氟沙星的抗性。
结果:169名患者(83名男性),平均年龄43.6±13.1岁。粪便中幽门螺杆菌的患病率为89.9%(152/169),胃活检样本中为90.5%(153/169)。在这项研究中使用的分子诊断表现出99.3%的灵敏度和100%的特异性,导致诊断准确率为99.6%。粪便中对克拉霉素的耐药性为36.1%(61/169),胃活检样本中为44.4%(75/169)。克拉霉素耐药的分子检测显示灵敏度为96.8%,特异性为86.8%,总体诊断准确率为90.5%。此外,粪便和胃活检样本对左氧氟沙星的耐药性为22.5%(38/169)和26.6%(45/169),分别。分子检测的灵敏度为80.9%,特异性为94.3%,导致90.5%的诊断准确率。
结论:实施基于实时PCR的H.pylori感染筛查以及粪便中对克拉霉素和左氧氟沙星的耐药性可能会提高根除治疗的成功率。
OBJECTIVE: Helicobacter pylori (H. pylori) is a globally prevalent bacterium that increases the risk of developing various gastrointestinal diseases, including gastric adenocarcinoma. This study aimed to evaluate the performances of real-time PCR assay in detecting H. pylori infection, as well as clarithromycin and
levofloxacin resistance, in both stool and gastric biopsy specimens.
METHODS: Stool and gastric biopsy specimens were collected from patients within one to three days post-hospitalization. All patients were analyzed for H. pylori infection and resistance to clarithromycin and
levofloxacin using a real-time PCR based molecular assay.
RESULTS: 169 patients (83 males) with a mean age of 43.6±13.1 years were included in the study. The prevalence of H. pylori was 89.9% (152/169) in stool and 90.5% (153/169) in gastric biopsy samples. The molecular diagnostics employed in this study exhibited a sensitivity of 99.3% and a specificity of 100%, resulting in a diagnostic accuracy rate of 99.6%. Resistance to clarithromycin was 36.1% (61/169) in stool and 44.4% (75/169) in gastric biopsy samples. The molecular tests for clarithromycin resistance demonstrated a sensitivity of 96.8% and a specificity of 86.8%, with an overall diagnostic accuracy of 90.5%. Furthermore, resistance to
levofloxacin was 22.5% (38/169) and 26.6% (45/169) in stool and gastric biopsy samples, respectively. The molecular test demonstrated a sensitivity of 80.9% and a specificity of 94.3%, resulting in a diagnostic accuracy of 90.5%.
CONCLUSIONS: The implementation of real-time PCR-based screening for H. pylori infection and resistance to clarithromycin and
levofloxacin in the stool may enhance the success rate of eradication therapy.