title: Gastric wash-based molecular testing for antibiotic resistance in Helicobacter pylori.
abstract: BACKGROUND
  A number of noninvasive tests have been developed to establish the presence of Helicobacter pylori infection. However, thus far these tests have only been capable of detecting its presence. An increasing number of antibiotic-resistant H. pylori infections have been reported and they are known to be correlated with 23S rRNA single nucleotide polymorphisms (SNPs). We hypothesized that genomic analysis of H. pylori recovered from gastric washes could not only be less invasive, but also useful as a screening test and for assessing the outcome of eradication therapy.
  
  
  METHODS
  Biopsy specimens and gastric washes were collected from 100 patients during endoscopic examination. Then we analyzed 23S rRNA, ureA, and cagA genes using PCR and high-throughput pyrosequencing analysis.
  
  
  RESULTS
  Forty-five percent (44/97) of patients tested positive for ureA and 42.3% (41/97) tested positive by a rapid urease test. One hundred percent (35/35) of patients who tested positive by both methods were observed to have the cagA gene. Among these 35 patients, 23S rRNA SNPs were present in 34.3% (12/35).
  
  
  CONCLUSIONS
  Gastric wash-based PCR and a pyrosequencing assay were used to rapidly detect and estimate the number of 23S rRNA SNPs in clinical isolates of H. pylori. Not only is this a less invasive technique, but it can also diagnose drug resistance.
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
authors: Satoshi
authors: S
authors: Baba
authors: Yoshichika
authors: Y
authors: Oishi
authors: Yoshiyuki
authors: Y
authors: Watanabe
authors: Ritsuko
authors: R
authors: Oikawa
authors: Ryo
authors: R
authors: Morita
authors: Yoshihito
authors: Y
authors: Yoshida
authors: Tetsuya
authors: T
authors: Hiraishi
authors: Tadateru
authors: T
authors: Maehata
authors: Yoshihiko
authors: Y
authors: Nagase
authors: Yasunobu
authors: Y
authors: Fukuda
authors: Midori
authors: M
authors: Nakazawa
authors: Shinya
authors: S
authors: Ishigouoka
authors: Nobuhiro
authors: N
authors: Hattori
authors: Hiromu
authors: H
authors: Suzuki
authors: Minoru
authors: M
authors: Toyota
authors: Hirohumi
authors: H
authors: Niwa
authors: Michihiro
authors: M
authors: Suzuki
authors: Fumio
authors: F
authors: Itoh
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D000942:Antigens, Bacterial / Q000235:genetics; D001426:Bacterial Proteins / Q000235:genetics; D001706:Biopsy; D017291:Clarithromycin / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D005260:Female; D005751:Gastric Lavage; D005753:Gastric Mucosa / Q000378:metabolism / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D016480:Helicobacter pylori / Q000235:genetics* / Q000302:isolation & purification; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D020641:Polymorphism, Single Nucleotide; D012338:RNA, Ribosomal, 23S / Q000235:genetics*; D064750:Rabeprazole; D017423:Sequence Analysis, RNA; D018709:Statistics, Nonparametric; D014510:Urease / Q000235:genetics / Q000378:metabolism
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D012338:RNA, Ribosomal, 23S; C080866:cagA protein, Helicobacter pylori; D064750:Rabeprazole; D000658:Amoxicillin; D014510:Urease; D017291:Clarithromycin