title: Routine use of real-time PCR for detection of Helicobacter pylori and of clarithromycin resistance mutations.
abstract: 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.
authors.affiliation: 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.
authors.forename: Jacques
authors.initials: J
authors.lastname: Tankovic
authors.forename: Marie-Thérèse
authors.initials: MT
authors.lastname: Chaumette-Planckaert
authors.forename: Lionel
authors.initials: L
authors.lastname: Deforges
authors.forename: Nathalie
authors.initials: N
authors.lastname: Launay
authors.forename: Jeanne-Marie
authors.initials: JM
authors.lastname: Le Glaunec
authors.forename: Claude-James
authors.initials: CJ
authors.lastname: Soussy
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Delchier
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D003470:Culture Media; D004279:DNA, Viral; D012338:RNA, Ribosomal, 23S; D017291:Clarithromycin