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Background  Macrolide resistance in  Helicobacter pylori  is the major risk factor for treatment failure when using a proton pump inhibitor-clarithromycin containing therapy. Macrolide resistance is due to a few mutations on the 23S ribomosal subunit encoded by the 23S rRNA gene. The present study aimed at investigating the performance of the dual priming oligonucleotide (DPO)-PCR kit named Seeplex ®  ClaR- H. pylori  ACE detection designed to detect  H. pylori  and two types of point mutations causing clarithromycin resistance in  H. pylori .    Methods  The performance of Seeplex ®  ClaR- H. pylori  ACE detection was evaluated on 127 gastric biopsies in comparison to conventional bacterial culture followed by the determination of susceptibility to clarithromycin by E-test, as well as by an in-house real-time PCR using a fluorescence resonance energy transfer (FRET) technology.    Results  Considering culture as the reference test, the sensitivity of DPO-PCR and real-time FRET-PCR was 97.7% and 100% while specificity was 83.1% and 80.7%, respectively. However, both PCR were concordant in detecting 14  H. pylori  positive cases which were negative by culture. Globally, E-test and DPO-PCR were concordant with regard to clarithromycin susceptibility in 95.3% of the cases (41/43), while real-time FRET-PCR and DPO-PCR were concordant in 95% (57/60).    Conclusion  The DPO-PCR is an interesting tool to detect  H. pylori  on gastric biopsies and to study its susceptibility to clarithromycin in laboratories that cannot perform real-time PCR assays.

DPO multiplex PCR as an alternative to culture and susceptibility testing to detect Helicobacter pylori and its resistance to clarithromycin