A new non-invasive tool for guiding H. pylori treatment

Current guidelines recommend that all patients with documented H. pylori infection should be treated with an appropriate antibacterial therapy. Clarithromycin-based regimens are commonly used as a first line therapy in H. pylori positive patients, however soon after the introduction of clarithromycin-based therapies, treatment failures associated with resistance to clarithromycin were reported. In this study, we evaluated the feasibility of using a non-invasive sample type, stool, to detect the presence of H. pylori by molecular methods while concurrently detecting mutations associated with the resistance to clarithromycin. The sensitivity for H. pylori detection by PCR was 93.8% compared to composite reference methods with gastric tissue biopsy. Out of 213 true positives that were sequenced, 36.2% showed point mutations associated with CLA resistance (A2142C, A2142G, A2143G). The correlation of sequencing and PCR was 98%.  The correlation of sequencing and eradication of the infection was 86%.  The results of this test may be used as a tool for guiding treatment of H. pylori infection.