Clinical utility of fecal Sanger sequencing and PCR alongside gastric biopsy E-test for Helicobacter pylori resistance to clarithromycin and quinolone

Key Points

• To evaluate the clinical utility of fecal Sanger sequencing and PCR for detecting Helicobacter pylori resistance to antibiotics.
• Analyzed primary resistance rates for clarithromycin and quinolones in Helicobacter pylori.
• Conducted non-invasive fecal PCR and Sanger sequencing on 23S rRNA and gyrA mutations.
• Compared findings with invasive E-test results for validation.
• Found primary resistance to clarithromycin and quinolones exceeds 65%.
• Observed resistance rates increase with age.
• Fecal PCR and Sanger sequencing showed ≥85% agreement with invasive E-test results.