Novel chromogenic medium-based method for the rapid detection of Helicobacter pylori drug resistance
Abstract
BACKGROUND: Helicobacter pylori (H. pylori), a globally prevalent pathogen, is exhibiting increasing rates of antimicrobial resistance. However, clinical implementation of pre-treatment susceptibility testing remains limited due to the organism's fastidious growth requirements and prolonged culture time.
AIM: To propose a novel detection method utilizing antibiotic-supplemented media to inhibit susceptible strains, while resistant isolates were identified through urease-mediated hydrolysis of urea, inducing a phenol red color change for visual confirmation.
METHODS: Colombia agar was supplemented with urea, phenol red, and nickel chloride, and the final pH was adjusted to 7.35. Antibiotic-selective media were prepared by incorporating amoxicillin (0.5 μg/mL), clarithromycin (2 μg/mL), metronidazole (8 μg/mL), or levofloxacin (2 μg/mL) into separate batches. Gastric antral biopsies were homogenized and inoculated at 1.0 × 105 CFU onto the media, and then incubated under microaerobic conditions at 37 °C for 28-36 hours. Resistance was determined based on a color change from yellow to pink, and the results were validated via broth microdilution according to Clinical and Laboratory Standards Institute guidelines.
RESULTS: After 28-36 hours of incubation, the drug-resistant H. pylori isolates induced a light red color change in the medium. Conversely, susceptible strains (H. pylori 26695 and G27) produced no visible color change. Compared with the conventional 11-day protocol,…
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