Helicobacter pylori heteroresistance to clarithromycin in adults—New data by in situ detection and improved concept

• DOI: 10.1111/hel.12670
• Publication Date: 2019-11-08T09:56:07Z
• Authors: Éva Kocsmár; Ildikó Kocsmár; György Miklós Buzás; Ildikó Szirtes; Judit Wacha; Alajos Takáts; István Hritz; Zsuzsa Schaff; Massimo Rugge; Matteo Fassan; András Kiss; Gábor Lotz
• Keywords: Adult; Male; 0303 health sciences; Helicobacter pylori; Biopsy; Gastroenterology; General Medicine; Middle Aged; Anti-Bacterial Agents; Helicobacter Infections; 3. Good health; clarithromycin resistance; FISH; Helicobacter pylori; heteroresistance; in situ hybridization; 03 medical and health sciences; Infectious Diseases; Clarithromycin; Drug Resistance, Bacterial; Humans; Female; In Situ Hybridization, Fluorescence; Aged

Abstract Background Clarithromycin (Cla) heteroresistance of Helicobacter pylori ( H ) infections is commonly assessed by comparing the resistance status antrum and corpus biopsy samples demonstrating discrepancy between them (interniche heteroresistance). However, fluorescence in situ hybridization (FISH) technique capable showing synchronous presence susceptible resistant bacteria (intraniche heteroresistance), enabling detection heteroresistant populations within one sample. Materials Methods Antrum specimens 305 ‐infected patients were investigated with an rRNA‐targeted Cla‐resistance FISH test. Anamnestic data collected from institutional electronic register. Prevalence rates susceptible, homo‐ cases correlated anamnestic clinicopathological data. Results Overall rate was 23.9% (73 cases), consisting 35 (11.5%) homoresistant 38 (12.5%) cases. Thirty‐five had at least site where present simultaneously. From this subset, 20 demonstrated intraniche on both sites. Prior Cla‐based eradication attempts more frequent than P < .001, respectively). Cla‐containing therapy eradicated a significantly lower comparison = .0112), but effectively homoresistants .0393). Conclusions The most type Cla‐heteroresistance coexistence same location A previous attempt predisposes to infection. Heteroresistance characterized non‐eradication‐related background intermediate characteristics many respects when compared