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

[31] Epidemiology, clinical impacts and current clinical management of Helicobacter pylori infection [J].

Mitchell, Hazel ;

Katelaris, Peter .

MEDICAL JOURNAL OF AUSTRALIA, 2016, 204 (10) :376-+

[32] Helicobacter pylori clarithromycin resistance detected by Etest and TaqMan real-time polymerase chain reaction: a comparative study [J].

Monno, Rosa ;

Giorgio, Floriana ;

Carmine, Panella ;

Soleo, Leonardo ;

Cinquepalmi, Vittoria ;

Ierardi, Enzo .

APMIS, 2012, 120 (09) :712-717

[33] Diagnostic Accuracy of a Noninvasive Test for Detection of Helicobacter pylori and Resistance to Clarithromycin in Stool by the Amplidiag H. pylori plus ClariR Real-Time PCR Assay [J].

Pichon, Maxime ;

Pichard, Benoit ;

Barrioz, Thierry ;

Plouzeau, Chloe ;

Croquet, Vincent ;

Fotsing, Ginette ;

Cheron, Alexandre ;

Vuillemin, Eric ;

Wangermez, Marc ;

Haineaux, Paul-Arthur ;

Vasseur, Philippe ;

Thiebault, Quentin ;

Lefevre, Clemence ;

de Singly, Anais ;

Cremniter, Julie ;

Broutin, Lauranne ;

Michaud, Anthony ;

Silvain, Christine ;

Burucoa, Christophe .

JOURNAL OF CLINICAL MICROBIOLOGY, 2020, 58 (04)

[34] Bivariate analysis of sensitivity and specificity produces informative summary measures in diagnostic reviews [J].

Reitsma, JB ;

Glas, AS ;

Rutjes, AWS ;

Scholten, RJPM ;

Bossuyt, PM ;

Zwinderman, AH .

JOURNAL OF CLINICAL EPIDEMIOLOGY, 2005, 58 (10) :982-990

[35] Development of a highly sensitive method for detection of clarithromycin-resistant Helicobacter pylori from human feces [J].

Rimbara, E ;

Noguchi, N ;

Yamaguchi, T ;

Narui, K ;

Kawai, T ;

Sasatsu, M .

CURRENT MICROBIOLOGY, 2005, 51 (01) :1-5

[36] Optimal therapy for Helicobacter pylori infections [J].

Rimbara, Emiko ;

Fischbach, Lori A. ;

Graham, David Y. .

NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY, 2011, 8 (02) :79-88

[37] Evaluation of Clarithromycin Resistance in Helicobacter pylori Obtained from Culture Isolates, Gastric Juice, and Feces [J].

Rimbara, Emiko ;

Tamura, Remi ;

Tanuma, Michiya ;

Noguchi, Norihisa ;

Kawai, Takashi ;

Sasatsu, Masanori .

HELICOBACTER, 2009, 14 (02) :156-157

[38] Clinical Evaluation of a Real-Time PCR Assay for Simultaneous Detection of Helicobacter pylori and Genotypic Markers of Clarithromycin Resistance Directly from Stool [J].

Rolon, Rebecca Marrero ;

Cunningham, Scott A. ;

Mandrekar, Jayawant N. ;

Polo, Erin T. ;

Patel, Robin .

JOURNAL OF CLINICAL MICROBIOLOGY, 2021, 59 (05)

[39] Prevalence of Antibiotic Resistance in Helicobacter pylori: A Systematic Review and Meta-analysis in World Health Organization Regions [J].

Savoldi, Alessia ;

Carrara, Elena ;

Graham, David Y. ;

Conti, Michela ;

Tacconelli, Evelina .

GASTROENTEROLOGY, 2018, 155 (05) :1372-+

[40] Novel real-time PCR assay for detection of Helicobacter pylori infection and simultaneous clarithromycin susceptibility testing of stool and biopsy specimens [J].

Schabereiter-Gurtner, C ;

Hirschl, AM ;

Dragosics, B ;

Hufnagl, P ;

Puz, S ;

Kovách, Z ;

Rotter, M ;

Makristathis, A .

JOURNAL OF CLINICAL MICROBIOLOGY, 2004, 42 (10) :4512-4518

← 1 2 3 4 5 →