Gastric wash-based molecular testing for antibiotic resistance in helicobacter pylori

Satoshi Baba, Yoshichika Oishi, Yoshiyuki Watanabe, Ritsuko Oikawa, Ryo Morita, Yoshihito Yoshida, Tetsuya Hiraishi, Tadateru Maehata, Yoshihiko Nagase, Yasunobu Fukuda, Midori Nakazawa, Shinya Ishigouoka, Nobuhiro Hattori, Hiromu Suzuki, Minoru Toyota, Hirohumi Niwa, Michihiro Suzuki, Fumio Itoh

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)


Background: A number of noninvasive tests have been developed to establish the presence of Helicobacter pylori infection. However, thus far these tests have only been capable of detecting its presence. An increasing number of antibiotic-resistant H. pylori infections have been reported and they are known to be correlated with 23S rRNA single nucleotide polymorphisms (SNPs). We hypothesized that genomic analysis of H. pylori recovered from gastric washes could not only be less invasive, but also useful as a screening test and for assessing the outcome of eradication therapy. Methods: Biopsy specimens and gastric washes were collected from 100 patients during endoscopic examination. Then we analyzed 23S rRNA, ureA, and cagA genes using PCR and high-throughput pyrosequencing analysis. Results: Forty-five percent (44/97) of patients tested positive for ureA and 42.3% (41/97) tested positive by a rapid urease test. One hundred percent (35/35) of patients who tested positive by both methods were observed to have the cagA gene. Among these 35 patients, 23S rRNA SNPs were present in 34.3% (12/35). Conclusions: Gastric wash-based PCR and a pyrosequencing assay were used to rapidly detect and estimate the number of 23S rRNA SNPs in clinical isolates of H. pylori. Not only is this a less invasive technique, but it can also diagnose drug resistance.

Original languageEnglish
Pages (from-to)299-305
Number of pages7
Issue number4
Publication statusPublished - 2011 Dec
Externally publishedYes


  • Diagnosis
  • Gastric cancer
  • Gastric washes
  • Helicobacter pylori

ASJC Scopus subject areas

  • Gastroenterology


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