Routine use of real-time PCR for detection of Helicobacter pylori and of clarithromycin resistance mutations.
OBJECTIVE
We previously showed that real-time PCR was a reliable technique for coupled detection of Helicobacter pylori and clarithromycin resistance mutations directly from biopsies. After one year of use, we compared its performances to those of histology, which remains the most employed method for H. pylori detection from gastric biopsies.


METHODS
518 subjects underwent endoscopy during the year 2003 with biopsies taken for H. pylori detection by histology, PCR, and in case of discrepancy between the two techniques, by culture.


RESULTS
The prevalence of infection, defined as positive PCR and histology, and in case of discrepancy as a positive culture, was 30% (163/518). The percentage of concordance between the two tests was 87.8% (455/518). The sensitivity, specificity, positive and negative predictive values of PCR were 98.2%, 97.5%, 94.7%, and 99.1%, respectively. The corresponding performances of histology were 87.7%, 91.3%, 82.2%, and 94.2%, respectively (p<0.001). The prevalence of clarithromycin resistance was 30%.


CONCLUSIONS
PCR is more accurate in routine than histology and permits easy determination of clarithromycin resistance, which is useful in countries like France where the prevalence of resistance is high.
Tankovic
Jacques
J
Laboratoire de Bactériologie-Virologie, Hôpital Saint-Antoine and Centre Hospitalo-Universitaire Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Université Paris VI, 184 rue du faubourg Saint-Antoine, Paris.
Chaumette-Planckaert
Marie-Thérèse
MT
Deforges
Lionel
L
Launay
Nathalie
N
Le Glaunec
Jeanne-Marie
JM
Soussy
Claude-James
CJ
Delchier
Jean-Charles
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001706:Biopsy; D017291:Clarithromycin / Q000494:pharmacology*; D003470:Culture Media; D004279:DNA, Viral / Q000302:isolation & purification; D024881:Drug Resistance, Bacterial; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy / Q000453:epidemiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000191:economics / Q000379:methods*; D011237:Predictive Value of Tests; D012338:RNA, Ribosomal, 23S / Q000235:genetics; D012680:Sensitivity and Specificity; D013270:Stomach / Q000382:microbiology* / Q000473:pathology
D000900:Anti-Bacterial Agents; D003470:Culture Media; D004279:DNA, Viral; D012338:RNA, Ribosomal, 23S; D017291:Clarithromycin