Detection of Clarithromycin Resistance in Helicobacter pylori: Advancing Diagnostic Approaches

Article information

Korean J Helicobacter Up Gastrointest Res. 2025;25(1):1-2

Publication date (electronic) : 2025 March 7

doi : https://doi.org/10.7704/kjhugr.2025.0014

¹Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea

²Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea

Corresponding author Yong Hwan Kwon, MD, PhD Department of Internal Medicine, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Korea E-mail: tear9754006@yahoo.co.kr

Received 2025 February 6; Accepted 2025 February 7.

Helicobacter pylori is a major bacterial pathogen that infects nearly half of the global population and is a leading cause of chronic gastritis, peptic ulcers, and gastric cancer [1]. Eradication therapy, particularly clarithromycin-based regimens, has been the cornerstone of treatment [2]. However, the rising prevalence of clarithromycin-resistant H. pylori strains has significantly compromised treatment efficacy, necessitating the development of more advanced diagnostic techniques to guide therapy selection [3-5].

This study provides an important contribution to the ongoing efforts in diagnosing H. pylori infection and identifying clarithromycin resistance using molecular techniques [6]. Given the increasing prevalence of clarithromycin-resistant H. pylori strains, rapid and accurate diagnostic tools are essential for guiding effective eradication therapies. This study evaluates two real-time polymerase chain reaction assays—Allplex^TM H. pylori & ClariR Assay and Ezplex^® HP-CLA—comparing their performance against traditional diagnostic methods (rapid urease test) and H. pylori culture and antibiotic susceptibility test [6]. Molecular diagnostics have gained prominence over culture-based methods due to their efficiency and reliability in detecting resistance-associated mutations [7]. The findings demonstrate that both AllplexTM and Ezplex^® exhibit high diagnostic accuracy, with Ezplex^® achieving a remarkable eradication rate of 90.7% when used to guide tailored therapy. The study also highlights the clinical relevance of genotypic resistance detection in optimizing treatment strategies, potentially improving patient outcomes and reducing antibiotic misuse [6].

Overall, this study is a valuable addition to the field, reinforcing the importance of molecular testing in H. pylori management [6]. Clinicians and microbiologists should consider integrating these advanced diagnostic tools into routine practice to enhance treatment efficacy and combat antibiotic resistance.

Notes

Availability of Data and Material

Data sharing not applicable to this article as no datasets were generated or analyzed during the study.

Conflicts of Interest

The author has no financial conflicts of interest.

Funding Statement

None

Acknowledgements

None

References

1. Park YH, Kim N. Review of atrophic gastritis and intestinal metaplasia as a premalignant lesion of gastric cancer. J Cancer Prev 2015;20:25–40.

2. Rokkas T, Gisbert JP, Malfertheiner P, et al. Comparative effectiveness of multiple different first-line treatment regimens for Helicobacter pylori infection: a network meta-analysis. Gastroenterology 2021;161:495–507.e4.

3. Boyanova L, Hadzhiyski P, Kandilarov N, Markovska R, Mitov I. Multidrug resistance in Helicobacter pylori: current state and future directions. Expert Rev Clin Pharmacol 2019;12:909–915.

4. Savoldi A, Carrara E, Graham DY, Conti M, Tacconelli E. Prevalence of antibiotic resistance in Helicobacter pylori: a systematic review and meta-analysis in World Health Organization regions. Gastroenterology 2018;155:1372–1382.e17.

5. Arenas A, Serrano C, Quiñones L, et al. High prevalence of clarithromycin resistance and effect on Helicobacter pylori eradication in a population from Santiago, Chile: cohort study and meta-analysis. Sci Rep 2019;9:20070.

6. Kim TW, Lee WS, Yoon DJ, Kim I, Kim JS. Detection of clarithromycin resistance in Helicobacter pylori using Allplex ™ H. pylori & ClariR Assay and the Ezplex ^® HP-CLA real-time PCR kits. Korean J Helicobacter Up Gastrointest Res 2025;25:42–47.

7. Wang YH, Li Z, Wang L, et al. A systematic review and meta-analysis of genotypic methods for detecting antibiotic resistance in Helicobacter pylori. Helicobacter 2018;23e12467.

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