Multicentre, cross-sectional surveillance of Helicobacter pylori prevalence and antibiotic resistance to clarithromycin and levofloxacin in urban China using the string test coupled with quantitative PCR

Wang, Liang; Li, Zhengkang; Tay, Chin Yen; Marshall, Barry J; Gu, Bing; Tian, Yan; Dai, Xubo; Du, Hong; Dai, Qiong; Feng, Cui; Fang, Qi; Huang, Yanjiang; Hu, Yizhong; He, Min; Hu, Guochu; Huang, Hui; Li, Qixin; Liu, Mingbo; Li, Junhong; Luo, Jinhua; Lin, Zhifang; Li, Fen; Liu, Haitao; Xia, Dong; Man, Baohua; Ma, Jianhong; Tang, Shifu; Tang, Bofu; Wang, Jiliang; Wu, Tao; Wang, Xiaoling; Wang, Handong; Wang, Shuchun; Xu, Jing; Xu, Jiancheng; Xie, Qingquan; Xie, Rongzhang; Ye, Yunxian; Yuan, Gailing; Zhu, Xingcheng; Zhao, Shulei; Zou, Wenbi; Zhang, Liyan; Zhou, Bin

doi:10.1016/s2666-5247(24)00027-2

Cited by 4 publications

(2 citation statements)

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“…Regional drug resistance data and previous research data are important guidance for the selection of empirical eradication treatment regimens [2]. As the first multicenter randomizedcontrolled trial of dual therapy in the region (Shandong Province) with a high prevalence of clarithromycin resistance, this study provided significant guidance for empirical drug use in the region [23]. Furthermore, dosage, frequency, and duration are key factors in optimizing dual therapy.…”

Section: Discussionmentioning

confidence: 92%

Fourteen‐Day Tegoprazan–Amoxicillin Dual Therapy as the First‐Line Treatment of Helicobacter pylori Infection (SHARE2301): A Multicenter, Noninferiority, Randomized Clinical Trial

Kong,

Mirza,

Zhang

et al. 2024

Helicobacter

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BackgroundPotassium‐competitive acid blockers have demonstrated enormous potential in the eradication treatment of Helicobacter pylori infection, with tegoprazan being one of the representatives. The available data on the safety and efficacy of tegoprazan in dual therapy are limited.Materials and MethodsThe multicenter, noninferiority, randomized‐controlled trial was conducted from May 2023 to March 2024. Treatment‐naive subjects were randomly assigned (1:1) to enter either the tegoprazan–amoxicillin (TA) group (tegoprazan 50 mg twice daily and amoxicillin 750 mg four times daily) or the esomeprazole–amoxicillin (EA) group (esomeprazole 20 mg and amoxicillin 750 mg all four times daily), with a duration for 14 days. The primary outcome was eradication rate as determined by 13C‐urea breath test, including per‐protocol (PP) analysis and intention‐to‐treat (ITT) analysis. Secondary outcomes were adverse events and compliance.ResultsA total of 368 individuals were included in the randomization. The eradication rates in the EA group and the TA group were 84.2% and 85.8%, respectively, according to an ITT analysis (p = 0.77), and 88.5% and 88.2%, respectively, according to PP analysis (p = 1.00). The eradication rates for the TA group were not inferior to those of the EA group in both PP (p = 0.0023) and ITT analyses (p = 0.0009). There were no significant statistical differences in the incidence of adverse events and compliance between the two groups. The multivariate logistic regression analysis revealed that poor compliance increased the risk of eradication failure (p < 0.001).ConclusionsDual therapy containing tegoprazan is safe and effective to be considered as a clinical first‐line treatment option, but further optimization involving antimicrobial susceptibility testing and adjustments in dosage and frequency is warranted.Trial RegistrationClinicalTrials.gov ID: NCT05870683.

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Section: Discussionmentioning

confidence: 92%

Fourteen‐Day Tegoprazan–Amoxicillin Dual Therapy as the First‐Line Treatment of Helicobacter pylori Infection (SHARE2301): A Multicenter, Noninferiority, Randomized Clinical Trial

Kong,

Mirza,

Zhang

et al. 2024

Helicobacter

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“…Moreover, they reported a high eradication rate of 91.8% with genotypic resistancetailored bismuth quadruple therapy [82]. The value of the string test coupled with RT-qPCR for detecting H. pylori resistance to clarithromycin and levofloxacin has also been validated in urban China in a recent multicenter, cross-sectional study [83]. Therefore, the string-qPCR test is a feasible method that can facilitate the detection of genotypic antibiotic resistance in H. pylori, and thus further improve the clinical practice in the treatment of H. pylori infection.…”

Section: Novel Techniques For Collecting Specimens For Genotypic-base...mentioning

confidence: 99%

Rapid Non-Invasive Techniques for Detecting Antibiotic Resistance in Helicobacter pylori: An Update and Clinical Applications

Zhou,

Zhang,

Qing-Jiao Liao

et al. 2024

Towards the Eradication of Helicobacter Pylori Infection - Rapid Diagnosis and Precision Treatment

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The global prevalence of Helicobacter pylori infection remains high, posing a significant health challenge worldwide. The efficacy of anti-H. pylori antibiotic-based regimens is compromised by the increasing antibiotic resistance in H. pylori. Thus, it is important to detect antibiotic resistance in H. pylori to ensure appropriate and effective treatment strategies. Currently, conventional culture-based methods are used for detecting antibiotic resistance (so-called phenotypic resistance) in H. pylori, but these methods are tedious and time-consuming (at least 72 h) and rely on the successful culture of H. pylori. Over the past decade, emerging genotypic or molecular techniques based on polymerase chain reaction or gene sequencing of DNA extracted from cultured H. pylori cells or H. pylori-containing specimens, such as gastric biopsy, stool, or saliva, have been developed to detect antibiotic resistance (so-called genotypic resistance) in H. pylori. These methods are rapid (usually within 4 h), non- or minimally invasive, cost-effective, and highly reproducible. Moreover, they can detect heteroresistant strains, enabling tailored therapy. The development and implementation of molecular techniques have significantly improved the accuracy and speed of identifying antibiotic resistance in H. pylori, allowing for more effective and personalized treatment strategies.

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Data-driven rapid detection of Helicobacter pylori infection through machine learning with limited laboratory parameters in Chinese primary clinics

Zhu,

Tan,

Huang

et al. 2024

Heliyon

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Multicentre, cross-sectional surveillance of Helicobacter pylori prevalence and antibiotic resistance to clarithromycin and levofloxacin in urban China using the string test coupled with quantitative PCR

Cited by 4 publications

References 8 publications

Fourteen‐Day Tegoprazan–Amoxicillin Dual Therapy as the First‐Line Treatment of Helicobacter pylori Infection (SHARE2301): A Multicenter, Noninferiority, Randomized Clinical Trial

Fourteen‐Day Tegoprazan–Amoxicillin Dual Therapy as the First‐Line Treatment of Helicobacter pylori Infection (SHARE2301): A Multicenter, Noninferiority, Randomized Clinical Trial

Rapid Non-Invasive Techniques for Detecting Antibiotic Resistance in Helicobacter pylori: An Update and Clinical Applications

Data-driven rapid detection of Helicobacter pylori infection through machine learning with limited laboratory parameters in Chinese primary clinics

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