Affiliation:
1. Department of Gastroenterology Peking University Third Hospital Beijing China
2. Research Center of Clinical Epidemiology Peking University Third Hospital Beijing China
Abstract
AbstractBackgroundEmpiric 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, I2 = 37.82) and specificity (Q = 60.34, p < .01, I2 = 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.
Funder
National Natural Science Foundation of China
Subject
Infectious Diseases,Gastroenterology,General Medicine
Reference48 articles.
1. Antimicrobial susceptibility testing forHelicobacter pyloriin times of increasing antibiotic resistance
2. Epidemiology, clinical impacts and current clinical management of Helicobacter pylori infection
3. Schistosomes, liver flukes and Helicobacter pylori. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Lyon, 7‐14 June 1994;IARC Monogr Eval Carcinog Risks Humans,1994
4. Kyoto global consensus report onHelicobacter pylorigastritis
5. Fifth Chinese national consensus report on the management of Helicobacter pylori infection;Liu G;Chinese J Intern Med,2017
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献