Diagnosis of Helicobacter pylori Infection in a Routine Testing Workflow: Effect of Bacterial Load and Virulence Factors.
Diagnosis of Helicobacter pylori Infection in a Routine Testing Workflow: Effect of Bacterial Load and Virulence Factors.
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常规检测流程中幽门螺杆菌感染的诊断：细菌负荷和毒力因子的影响。
DOI：
10.3390/jcm10132755
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发表时间：
2021-06-23
影响因子：
3.9
通讯作者：
Raymond J
中科院分区：
文献类型：
--
作者：
Gastli N;Allain M;Lamarque D;Abitbol V;Billoët A;Collobert G;Coriat R;Terris B;Kalach N;Raymond J
可靠的诊断方法是有效管理幽门螺杆菌感染的必要条件。组织学和培养是目前实践中最常见的侵入性方法，即使分子方法正在变得越来越重要。这些传统方法的性能差异很大。我们对1540名成人和504名儿童进行了一项回顾性研究，以评估细菌载量和cagA毒力因子对幽门螺杆菌感染检测性能的影响。毒力和组织学结果之间的联系也被调查了。以GlmM扩增证实的23S rRNA qPCR为金标准，培养和组织学检测的敏感性较低，分别为74.4%和73.3%。然而，在细菌载量较高的活检组织(qPCRCT<；30)中，它们的敏感性增强(>；90%)。CagA阳性与细菌载量高相关(94.9%)，从而导致培养阳性(94.3%)和幽门螺杆菌组织学检测(91.7%)，以及更严重的组织学损害(p<；0.001)。Hp组织学检测阴性者82例(91.1%)，培养阴性者119例(90%)(p<；0.001)。这项研究强调了传统培养和组织学的低敏感性，如果单独使用可能会导致假阴性诊断。在常规工作流程中，与cagA基因分型相关的幽门螺杆菌定量对于敏感和可靠的诊断、识别高危患者和管理根除治疗是必不可少的。
Reliable diagnostic methods are mandatory for effective management of Helicobacter pylori infection. Histology and culture are the most common invasive methods in current practice, even if molecular methods are gaining in importance. The performance of these conventional methods varies significantly. We conducted a retrospective study of 1540 adults and 504 children with gastric biopsies taken during endoscopy to assess the impact of bacterial load and the cagA virulence factor on the performance of H. pylori infection testing. The association between virulence and histology findings was also investigated. With 23S rRNA qPCR confirmed by glmM amplification as the gold standard, culture and histology had lower sensitivity, 74.4% and 73.3%, respectively. However, their sensitivity was enhanced (>90%) in biopsies with high bacterial load (qPCR Ct < 30). Positive cagA status of the strain was associated with high bacterial load (94.9%), thus resulting in more frequent positive culture (94.3%) and H. pylori histology detection (91.7%) and more severe lesions on histology (p < 0.001). Conversely, the cagA status of the strains was negative in 110/119 (92.4%) of biopsies with low bacterial load (qPCR Ct < 30), 82/90 (91.1%) with negative H. pylori histology detection and 119/131 (90%) with negative culture findings (p < 0.001). This study highlights the low sensitivity of conventional culture and histology that may lead to false negative diagnosis if used alone. H. pylori quantification associated with cagA genotyping in routine workflow are essential for a sensitive and reliable diagnosis, to identify patients at high risk and to manage eradication therapies.
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影响因子：
3.3
作者：
ElZimaity, HMT;Graham, DY;Genta, RM
通讯作者：
Genta, RM
影响因子：
9.4
作者：
Argent, RH;Zhang, YL;Atherton, JC
通讯作者：
Atherton, JC
影响因子：
4.4
作者：
Hirschl, Alexander M.;Makristathis, Athanasios
通讯作者：
Makristathis, Athanasios
DOI：
10.1097/mpg.0000000000000787
发表时间：
2015-09-01
影响因子：
2.9
作者：
Kalach, Nicolas;Gosset, Pierre;Raymond, Josette
通讯作者：
Raymond, Josette
影响因子：
9.8
作者：
Gonzalez, Carlos A.;Figueiredo, Ceu;Sanz-Anquela, J. M.
通讯作者：
Sanz-Anquela, J. M.