Individualized diagnosis and eradication therapy for Helicobacter pylori infection based on gene detection of clarithromycin resistance in stool specimens: A systematic review and meta-analysis

被引：19

作者：

Ren, Xinlu ^{[1
]}

Shi, Yanyan ^{[2
]}

Suo, Baojun ^{[1
]}

Yao, Xingyu ^{[1
]}

Lu, Haoping ^{[1
]}

Li, Cailing ^{[1
]}

Zhang, Yuxin ^{[1
]}

Zhou, Liya ^{[1
]}

Tian, Xueli ^{[1
,3
]}

Song, Zhiqiang ^{[1
,3
]}

机构：

[1] Peking Univ, Dept Gastroenterol, Hosp 3, Beijing, Peoples R China

[2] Peking Univ, Res Ctr Clin Epidemiol, Hosp 3, Beijing, Peoples R China

[3] Peking Univ, Dept Gastroenterol, Hosp 3, Beijing 100191, Peoples R China

来源：

HELICOBACTER | 2023年 / 28卷 / 03期

基金：

中国国家自然科学基金;

关键词：

clarithromycin resistance; diagnosis; Helicobacter pylori; individualized treatment; stool specimens; POLYMERASE-CHAIN-REACTION; ANTIBIOTIC-RESISTANCE; STRAINS;

D O I：

10.1111/hel.12958

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BackgroundEmpiric therapy for Helicobacter pylori infection results in significantly increased antibiotic resistance and decreased eradication efficacy. The genotypic testing of clarithromycin resistance from stool specimens is a promising method for individualized diagnosis and treatment. This study aimed to determine the status of research and application on this method through a systematic review and meta-analysis. MethodsPubMed, Embase, MEDLINE, and WAN FANG database were searched for relevant literature. The quality of included diagnostic articles was evaluated using the quality Assessment of Diagnostic Accuracy Studies-2 tool. A bivariate random-effect model was conducted to calculate the diagnostic accuracy of genotypic testing of clarithromycin resistance. ResultsA total of 16 diagnostic-related were included and analyzed after exclusions. The pooled sensitivity and specificity of diagnostic meta-analysis were 0.93 (95% confidence interval [CI]: 0.90-0.96) and 0.98 (95% CI: 0.93-1.00), respectively. The area under the curve (AUC) of the summary receiver operating characteristic was 0.97 (95% CI: 0.95-0.98). The genotypic testing in stool samples had heterogeneous sensitivity (Q = 37.82, p < .01, I-2 = 37.82) and specificity (Q = 60.34, p < .01, I-2 = 93.72) in detecting clarithromycin resistance. Purification method, stool sample weight, real-time PCR, and antimicrobial susceptibility testing as reference accounted for the heterogeneity of pooled sensitivity, while patient age, purification method, stool sample weight, and real-time PCR for the heterogeneity of pooled specificity. ConclusionThe genotypic testing of clarithromycin resistance from stool specimens is an accurate, convenient, noninvasive, and rapid detection technology, providing a definitive diagnosis of clarithromycin resistance and guiding the rational antibiotic selection.

引用

页数：11

共 48 条

[11] Efficacy of a tailored PCR-guided triple therapy in the treatment of Helicobacter pylori infection [J].

Delchier, J-C ;

Bastuji-Garin, S. ;

Raymond, J. ;

Megraud, F. ;

Amiot, A. ;

Cambau, E. ;

Burucoa, C. ;

Baloul, Samia ;

Barrioz, Thierry ;

Bizouard, Geoffray ;

Breuil, Jacques ;

Buzaglo, Gaelle ;

Chryssostalis, Ariane ;

Deforges, Lionel ;

Doumet, Sylva ;

Dray, Xavier ;

Durand-Zaleski, Isabelle ;

Ghaleh, Bijan ;

Grattard, Florence ;

Le Corvoisier, Philippe ;

Mangeol, Alain ;

Mion, Francois ;

Nahon, Stephane ;

Noussair, Latifa ;

Podglajen, Isabelle ;

Raskine, Laurent ;

Roure-Sobas, Chantal ;

Samaha, Elia ;

Zerbib, Franck .

MEDECINE ET MALADIES INFECTIEUSES, 2020, 50 (06) :492-499

[12] Conducting systematic reviews of diagnostic studies: Didactic guidelines [J].

Devillé W.L. ;

Buntinx F. ;

Bouter L.M. ;

Montori V.M. ;

De Vet H.C.W. ;

Van Der Windt D.A.W.M. ;

Bezemer P.D. .

BMC Medical Research Methodology, 2 (1) :1-13

[13] Comparison of the Diagnostic Performance of qPCR, Sanger Sequencing, and Whole-Genome Sequencing in Determining Clarithromycin and Levofloxacin Resistance in Helicobacter pylori [J].

Egli, Konrad ;

Wagner, Karoline ;

Keller, Peter M. ;

Risch, Lorenz ;

Risch, Martin ;

Bodmer, Thomas .

FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY, 2020, 10

[14] Detection of clarithromycin-resistant Helicobacter pylori in stool samples [J].

Fontana, C ;

Favaro, M ;

Pietroiusti, A ;

Pistoia, ES ;

Galante, A ;

Favalli, C .

JOURNAL OF CLINICAL MICROBIOLOGY, 2003, 41 (08) :3636-3640

[15] Polymerase chain reaction-based tests for detecting Helicobacter pylori clarithromycin resistance in stool samples: A meta-analysis [J].

Gong, Ren-Jie ;

Xu, Can-Xia ;

Li, Huan ;

Liu, Xiao-Ming .

WORLD JOURNAL OF CLINICAL CASES, 2021, 9 (01) :133-147

[16] Antimicrobial Susceptibility Testing for Helicobacter pylori Is Now Widely Available: When, How, Why [J].

Graham, David Y. ;

Moss, Steven F. .

AMERICAN JOURNAL OF GASTROENTEROLOGY, 2022, 117 (04) :524-528

[17] Primer for Development of Guidelines for Helicobacter pylori Therapy Using Antimicrobial Stewardship [J].

Graham, David Y. ;

Liou, Jyh-Ming .

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2022, 20 (05) :973-+

[18] Rational Helicobacter pylori Therapy: Evidence-Based Medicine Rather Than Medicine-Based Evidence [J].

Graham, David Y. ;

Lee, Yi-Chia ;

Wu, Ming-Shiang .

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2014, 12 (02) :177-+

[19] Helicobacter pylori Eradication Therapy Research: Ethical Issues and Description of Results [J].

Graham, David Y. .

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2010, 8 (12) :1032-1036

[20] Genotyping and antimicrobial resistance patterns of Helicobacter pylori in human and dogs associated with A2142G and A2143G point mutations in clarithromycin resistance [J].

Hamza, Dalia ;

Elhelw, Rehab ;

Elhariri, Mahmoud ;

Ragab, Eman .

MICROBIAL PATHOGENESIS, 2018, 123 :330-338

← 1 2 3 4 5 →