Real‐time PCR for Helicobacter pylori diagnosis. The best tools available

• Published in: Helicobacter (Cambridge, Mass.) Vol. 23; no. 5; pp. e12512 - n/a
• Main Authors: Bénéjat, Lucie, Ducournau, Astrid, Lehours, Philippe, Mégraud, Francis
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-10-2018
• Subjects: Antimicrobial agents; antimicrobial susceptibility testing; Biopsy; Clarithromycin; Culture; Diagnosis; Helicobacter Infections - diagnosis; Helicobacter pylori; Helicobacter pylori - genetics; Helicobacter pylori - pathogenicity; Humans; In Vitro Techniques; Materials selection; Mutation; Real-Time Polymerase Chain Reaction - methods; antimicrobial susceptibility testing; culture; clarithromycin
• ISSN: 1083-4389; 1523-5378
• DOI: 10.1111/hel.12512

Background
Knowledge of antimicrobial susceptibility, especially to macrolides, has become crucial for the management of Helicobacter pylori infection. Our aim was to evaluate two new PCR kits able to detect H. pylori in gastric biopsies as well as the mutations associated with macrolide resistance.
Materials and Methods
Two hundred successive biopsies (received from gastroenterologists all over France) were used. The two new kits tested were Amplidiag H. pylori+ClariR from Mobidiag Espoo, Finland, and RIDA®GENE H. pylori from R‐Biopharm, Darmstadt, Germany. Culture and a validated in‐house real‐time PCR were also performed, and in the case of a positive culture, Etest for clarithromycin was carried out. Discrepancies were solved by looking at the pathologic data.
Results
Culture was positive in 68 cases (34%), and with our in‐house real‐time PCR in these 68 cases plus 5 others (N = 73, 36%). All were also detected by the two new kits. In addition, RIDA®GENE H. pylori detected one more positive also detected by Amplidiag H. pylori+ClariR, and Amplidiag detected two other positives. Of these three additional cases, pathology confirmed the positivity for two. Only one case diagnosed by Amplidiag could be considered as a false positive. With regard to clarithromycin resistance, 22 cases were detected. The corresponding mutations (A2142/43G) were all identified with the three PCRs.
Conclusions
These two new kits which have an excellent sensitivity and specificity are convenient to use, adaptable to different thermocyclers, provide quick results, and deserve to be used in H. pylori diagnosis for a better choice of treatment regimen.