Usefulness of Dual Priming Oligonucleotide-Polymerase Chain Reaction for Diagnosis and Treatment of Helicobacter pylori

ABSTRACT

BACKGROUND/AIMS: The eradication rate of triple therapy for Helicobacter pylori is decreasing and one of the main causes is increased clarithromycin resistance. Recently, new methods have been introduced for the diagnosis of clarithromycin resistance. The aim of this study was to investigate the diagnostic rate of dual priming oligonucleotide-polymerase chain reaction (DPO-PCR) compared with histology and the eradication rates of triple therapy for clarithromycin susceptible H. pylori. MATERIALS AND METHODS: We retrospectively reviewed patients who underwent DPO-PCR exam and Giemsa stain for diagnosis of H. pylori between January, 2015 and March, 2016 at Incheon St. Mary's Hospital. Clarithromycin resistance of H. pylori was determined by DPO-PCR and the diagnostic accuracy of DPO-PCR was compared with histology. We also examined the eradication rates of triple therapy for clarithromycin susceptible strains. RESULTS: A total of 928 patients underwent DPO-PCR exam and Giemsa stain for diagnosis of H. pylori. The resistance rate for clarithromycin was 39%. The sensitivity and specificity of PCR exam compared with histology were 96.2% and 96.9%. The positive predictive values, negative predictive values, and accuracy were 90.54%, 98.87%, 96.88%, each. A total of 53 patients received triple therapy, and 39 patients completed ¹³C-urea breath test. The overall eradication rate was 97.4%. CONCLUSIONS: DPO-PPR showed high accuracy compared with biopsy and the eradication rates of triple therapy for clarithromycin susceptible H. pylori was 97.4%. DPO-PCR may be effective in determining treatment regimens in areas of high clarithromycin resistance.