title: GenoType HelicoDR test in the determination of antimicrobial resistance of Helicobacter pylori in Korea.
abstract: OBJECTIVE
  Antimicrobial resistance of Helicobacter pylori is most important factor in eradication success. GenoType HelicoDR test has been developed for rapid detection of antimicrobial resistance. The present study evaluated the clinical usefulness of GenoType HelicoDR test in Korea.
  
  
  METHODS
  To detect 23S rRNA for clarithromycin resistance and gyrA mutations for fluoroquinolone resistance, both DNA sequencing after minimal inhibitory test (MIC) and GenoType HelicoDR test were performed in H. pylori isolates from the gastric mucosa of 101 patients. The eradication results of clarithromycin and moxifloxacin-containing triple therapy were evaluated by the 23S rRNA and gyrA mutations.
  
  
  RESULTS
  For 42 isolates with A2143G mutation by GenoType HelicoDR, 83.3% (35/42) of concordance rate was estimated with DNA sequencing method and 85.7% (36/42) for MIC test. For 43 isolates with N87K mutation by GenoType HelicoDR, 71.1% (31/43) of concordance rate was estimated with DNA sequencing and 88.4% (38/43) for MIC test. The sensitivity and specificity of GenoType HelicoDR test in determination of 23S rRNA mutation were 94.9% and 87.1%, and those of gyrA 98.2% and 80.0%. The sensitivity and specificity of GenoType HelicoDR test in determination of clarithromycin resistance based on MIC test were 55.0% and 80.0%, for fluoroquinolone 74.4% and 70.0%.
  
  
  CONCLUSIONS
  GenoType HelicoDR test is useful to determine mutations responsible for clarithromycin or fluoroquinolone-containing eradication failure but has a limitation for the clinical applicability in determination of resistance.
authors: Department of Internal Medicine, Seoul National University Bundang Hospital , Seongnam, Gyeonggi-do , Korea.
authors: Jung Won
authors: JW
authors: Lee
authors: Nayoung
authors: N
authors: Kim
authors: Ryoung Hee
authors: RH
authors: Nam
authors: Ji Hyun
authors: JH
authors: Park
authors: Yoon Jin
authors: YJ
authors: Choi
authors: Jung Mogg
authors: JM
authors: Kim
authors: Joo Sung
authors: JS
authors: Kim
authors: Hyun Chae
authors: HC
authors: Jung
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017291:Clarithromycin / Q000494:pharmacology*; D027081:DNA Gyrase / Q000235:genetics; D004252:DNA Mutational Analysis; D004338:Drug Combinations; D024881:Drug Resistance, Bacterial / Q000235:genetics; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology*; D060005:Genotyping Techniques; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects* / Q000235:genetics*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D000077266:Moxifloxacin; D017354:Point Mutation; D012338:RNA, Ribosomal, 23S / Q000235:genetics; D056910:Republic of Korea; D012680:Sensitivity and Specificity
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D024841:Fluoroquinolones; D012338:RNA, Ribosomal, 23S; D027081:DNA Gyrase; D017291:Clarithromycin; D000077266:Moxifloxacin
keywords: GenoType HelicoDR test; Helicobacter pylori; antibiotics; resistance