Individualized Treatment Of Helicobacter Pylori Detection Of Gene Chips Used In The Clinical Evaluation Of Gastric Mucosa

Objective： Helicobacter pylori (H.pylori) is known to cause a range ofgastrointestinal infections pathogens gastritis, peptic ulcers, and even can causegastric cancer and gastric mucosa-associated lymphoid tissue lymphoma.Proton pumpinhibitors (PPI) and two antibiotics combined with triple therapy is widely used in thetreatment of Helicobacter pylori eradication, but eradication rate decreased year byyear, from the initial90%down80%or less. Studies have shown that the main reasonfor the failure of H. pylori eradication therapy is clarithromycin resistance and poorpatient compliance. Therefore, the detection of Helicobacter pylori resistance and tounderstand the history of the patient’s medication is an effective measure to preventfurther decline in H. pylori eradication rate. Research shows that the key to effectivetreatment and control of Helicobacter pylori infection is individualized treatment forpatients with drug-resistant cases, The prerequisite to achieve individualized treatmentis fast and accurate detection of drug resistance of Helicobacter pylori. The purpose ofthis study was to investigate H. pylori to clarithromycin and levofloxacin resistancephenotype and genotype relationships; The accuracy of detection and investigation ofH. pylori resistance to detect individual treatment microarray assay for Helicobacterpylori, Investigate clinical value of Helicobacter pylori gene chip individualizedtreatment.Method： Take the endoscopic gastric mucosa, isolated and cultured conductlevofloxacin and clarithromycin E-Test sensitivity assay, read the minimum inhibitoryconcentration (MIC) values to determine drug resistance. Extraction of mucosal DNA, the use of individualized treatment of Helicobacter pylori multiplex PCR assay forPCR amplification of samples for microarray detection; Amplified by PCRsequencing system2C19gene and sequenced to detect. Gastric clinical isolatesextracted DNA, multiplex PCR for gene microarray, PCR amplification of23S rRNAgene sequencing and gyrA genes and testing. PCR amplification of23S rRNA geneand strain gyrA gene, the plasmid construct bacteria, cultured bacteria picked cloneswere shaking culture, and sequencing.Results：1. individual treatment of Helicobacter pylori detection of gene chip samplesHangzhou gastric Helicobacter pylori test results with the results of susceptibilitytesting of clarithromycin and levofloxacin-resistant compliance rate of80%.2.Individualized treatment of Helicobacter pylori detection of gene chip samples ofHuzhou gastric Helicobacter pylori to clarithromycin and levofloxacin susceptibilitytest results and test results meet the above rate of90%.3. Individualized treatment ofHelicobacter pylori detection of gene chip isolates Hangzhou gastric resistance testingresults and susceptibility testing and sequencing of test results in line with rates above85%.4. There is mixed presence of Helicobacter pylori infection.Conclusions： Individualized treatment of Helicobacter pylori detection ofHelicobacter pylori on gastric mucosal resistance gene chip detection with highsensitivity and specificity. Clarithromycin and levofloxacin resistance test results withthe E-Test susceptibility test results and good consistency. Gene chip method is rapid,accurate, low cost, small workload, in an experiment to obtain simultaneouslydetecting metabolic type proton pump inhibitor and clarithromycin, levofloxacin, andto provide PPI and antibiotic selection basis.