title: Molecular detection ofHelicobacter pyloriantibiotic resistance in stoolvsbiopsy samples.
abstract: OBJECTIVE
  To compare (1) demographics in urea breath test (UBT)vsendoscopy patients; and (2) the molecular detection of antibiotic resistance in stoolvsbiopsy samples.
  
  
  METHODS
  Six hundred and sixteen adult patients undergoing endoscopy or a UBT were prospectively recruited to the study. The GenoType HelicoDR assay was used to detectHelicobacter pylori(H. pylori) and antibiotic resistance using biopsy and/or stool samples from CLO-positive endoscopy patients and stool samples from UBT-positive patients.
  
  
  RESULTS
  Infection rates were significantly higher in patients referred for a UBT than endoscopy (overall rates: 33%vs19%; treatment-naïve patients: 33%vs14.7%, respectively).H. pylori-infected UBT patients were younger thanH. pylori-infected endoscopy patients (41.4vs48.4 years, respectively,P< 0.005), with a higher percentage ofH. pylori-infected males in the endoscopy-compared to the UBT-cohort (52.6%vs33.3%,P= 0.03). The GenoType HelicoDR assay was more accurate at detectingH. pyloriinfection using biopsy samples than stool samples [98.2% (n= 54/55)vs80.3% (n=53/66),P< 0.005]. Subset analysis using stool and biopsy samples from CLO-positive endoscopy patients revealed a higher detection rate of resistance-associated mutations using stool samples compared to biopsies. The concordance rates between stool and biopsy samples for the detection ofH. pyloriDNA, clarithromycin and fluoroquinolone resistance were just 85%, 53% and 35%, respectively.
  
  
  CONCLUSIONS
  Differences between endoscopy and UBT patients provide a rationale for non-invasive detection ofH. pyloriantibiotic resistance. However, the GenoType HelicoDR assay is an unsuitable approach.
authors.affiliation: Denise E Brennan, Joseph Omorogbe, Mary Hussey, Donal Tighe, Grainne Holleran, Colm O'Morain, Sinéad M Smith, Deirdre McNamara, Department of Clinical Medicine, School of Medicine, Trinity College Dublin, 2 Dublin, Ireland.
authors.forename: Denise E
authors.initials: DE
authors.lastname: Brennan
authors.affiliation: Denise E Brennan, Joseph Omorogbe, Mary Hussey, Donal Tighe, Grainne Holleran, Colm O'Morain, Sinéad M Smith, Deirdre McNamara, Department of Clinical Medicine, School of Medicine, Trinity College Dublin, 2 Dublin, Ireland.
authors.forename: Joseph
authors.initials: J
authors.lastname: Omorogbe
authors.affiliation: Denise E Brennan, Joseph Omorogbe, Mary Hussey, Donal Tighe, Grainne Holleran, Colm O'Morain, Sinéad M Smith, Deirdre McNamara, Department of Clinical Medicine, School of Medicine, Trinity College Dublin, 2 Dublin, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: Hussey
authors.affiliation: Denise E Brennan, Joseph Omorogbe, Mary Hussey, Donal Tighe, Grainne Holleran, Colm O'Morain, Sinéad M Smith, Deirdre McNamara, Department of Clinical Medicine, School of Medicine, Trinity College Dublin, 2 Dublin, Ireland.
authors.forename: Donal
authors.initials: D
authors.lastname: Tighe
authors.affiliation: Denise E Brennan, Joseph Omorogbe, Mary Hussey, Donal Tighe, Grainne Holleran, Colm O'Morain, Sinéad M Smith, Deirdre McNamara, Department of Clinical Medicine, School of Medicine, Trinity College Dublin, 2 Dublin, Ireland.
authors.forename: Grainne
authors.initials: G
authors.lastname: Holleran
authors.affiliation: Denise E Brennan, Joseph Omorogbe, Mary Hussey, Donal Tighe, Grainne Holleran, Colm O'Morain, Sinéad M Smith, Deirdre McNamara, Department of Clinical Medicine, School of Medicine, Trinity College Dublin, 2 Dublin, Ireland.
authors.forename: Colm
authors.initials: C
authors.lastname: O'Morain
authors.affiliation: Denise E Brennan, Joseph Omorogbe, Mary Hussey, Donal Tighe, Grainne Holleran, Colm O'Morain, Sinéad M Smith, Deirdre McNamara, Department of Clinical Medicine, School of Medicine, Trinity College Dublin, 2 Dublin, Ireland.
authors.forename: Sinéad M
authors.initials: SM
authors.lastname: Smith
authors.affiliation: Denise E Brennan, Joseph Omorogbe, Mary Hussey, Donal Tighe, Grainne Holleran, Colm O'Morain, Sinéad M Smith, Deirdre McNamara, Department of Clinical Medicine, School of Medicine, Trinity College Dublin, 2 Dublin, Ireland.
authors.forename: Deirdre
authors.initials: D
authors.lastname: McNamara
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001944:Breath Tests; D004252:DNA Mutational Analysis; D004269:DNA, Bacterial / Q000235:genetics* / Q000302:isolation & purification; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D016099:Endoscopy, Gastrointestinal; D005243:Feces / Q000382:microbiology; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D016480:Helicobacter pylori / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009154:Mutation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results
chemical_list: D004269:DNA, Bacterial
keywords: Antibiotic resistance; Clarithromycin; Fluoroquinolone; Helicobacter pylori; Molecular methods