Roughly half of the world’s population harbors Helicobacter pylori, a bacterium commonly found in the stomach that can lead too serious health issues like ulcers and even cancer. Despite standard treatments involving antibiotics, infection persists in roughly 25% of cases due to growing bacterial resistance. Now, a new genomic sequencing approach offers a faster, more accurate way to determine antibiotic susceptibility, potentially allowing doctors to personalize H. pylori treatment plans and combat the rise of ineffective therapies. Researchers recently detailed their findings in The Lancet Microbe, outlining a method that coudl revolutionize how these common infections are managed.
Helicobacter pylori, a bacterium that infects the stomach, is remarkably widespread: roughly half of the world’s population carries it. While many individuals experience no symptoms, the infection – one of the most common chronic infections in humans – can lead to gastritis, peptic ulcers, and, over time, an increased risk of gastric cancer and a rare type of stomach lymphoma.
Current treatments aim to eradicate the bacteria to prevent these serious complications, typically involving a combination of antibiotics and medications to protect the stomach lining. However, these treatments are failing in approximately 25% of cases, often due to bacterial resistance to the antibiotics used, according to recent research.
Now, a team of scientists has developed a new method that could personalize treatment for H. pylori infections. Researchers, working with colleagues at the National Reference Center for Campylobacters and Helicobacters in France, utilized genomic sequencing to accurately predict the bacterium’s resistance to key antibiotics. This allows clinicians to determine the most effective therapy for each patient upfront – a “treatment à la carte,” as one researcher described it. The findings were recently published in The Lancet Microbe.
Challenges with Traditional Testing
Traditionally, determining antibiotic resistance involves bacterial culture – growing the bacteria in a lab to create a large enough population for diagnosis. This process is particularly difficult with H. pylori, and replicating results across different laboratories can be challenging.
The new method bypasses the need for bacterial cultures. Instead, it uses genomic sequencing to identify specific mutations that indicate resistance to clarithromycin and levofloxacin, two commonly used antibiotics in H. pylori treatment.
Researchers have created a catalog of genetic mutations that allows for resistance diagnosis with a single genomic analysis.
“Although a positive culture is still required to obtain the bacteria’s genome, additional cultures to identify resistances are not necessary, saving time and resources,” explained Álvaro Chines, a researcher at the Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (Fisabio) and a lead author of the study. “Moreover, the method is more precise and reproducible, avoiding errors associated with traditional testing.”
The team has created a catalog of genetic mutations that enables diagnosis of resistance through a single genomic analysis. They also estimated the global prevalence of these resistances, revealing significant regional variations. For example, up to 51.2% of strains in Southeast Asia were resistant to clarithromycin, while resistance to levofloxacin was less than 13%. Conversely, more than half of the strains from South Asia were resistant to levofloxacin, but less than 5% were resistant to clarithromycin.
Scalable Application
Researchers believe this technique has the potential for global implementation. It can be integrated into genomic diagnostic platforms and adapted to the needs of each region. “This technology can be used in clinical diagnosis to select the most appropriate treatment from the outset,” said Iñaki Comas, the study’s lead investigator and a researcher at the Spanish National Research Council (CSIC) at the Institute of Biomedicine of Valencia (IVB). He noted that the increasing use of genetic sequencing in hospitals, particularly since the COVID-19 pandemic, could facilitate the integration of this analysis for H. pylori. In essence, the methods used to detect the coronavirus could be adapted to investigate the stomach bacteria’s DNA in each case.
The method is also useful for epidemiological surveillance of antibiotic resistance and for developing new therapeutic strategies. In the long term, researchers hope it will contribute to reducing treatment failure and improving control of Helicobacter pylori infections worldwide. This research highlights the growing importance of precision medicine in tackling antibiotic resistance and improving patient outcomes.
