Helicobacter pyloriIs Not Eradicated after Triple Therapy: A Nested PCR Based Study

Abstract

Detection ofHelicobacter pyloriafter triple therapy is usually carried out by either rapid urease test (RUT), urea breath test (UBT), histology, bacterial isolation, and single round PCR or serological tests. In this study, antral biopsy specimens from 25 patients were tested forH. pyloriby RUT, culture, histology, and nested PCR in their antral biopsy specimens before and after treatment. Three genes, namely, heat shock protein (hsp60), phosphoglucosamine mutase (ureC), and flagellar export ATP synthase (fliI) ofH. pyloriwere targeted. Of the 25 antral biopsy specimens, the RUT, culture, histology, and nested PCR positivity dropped from 81.8% to 12%, 31% to 0%, 100 to 84%, and 100% to 92%, respectively, before and after therapy. Further,hsp60specific amplicons from 23 out of 25 patients gave identical restriction pattern, while 6fliIand 1ureCspecific amplicon produced different restriction pattern. Furthermore, variations infliIgene sequences inH. pyloriafter treatment were also confirmed by sequencing and comparedin silico. Nested PCR based detection ofH. pyloriis more sensitive method to detectH. pyloriafter therapy than culture, RUT, and histology. Further, this study suggests thatH. pyloriis not eradicated completely after triple therapy.