{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T15:44:02Z","timestamp":1784389442374,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T00:00:00Z","timestamp":1731369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009139","name":"Deutsches Zentrum f\u00fcr Infektionsforschung","doi-asserted-by":"publisher","award":["TTU 06.715_00"],"award-info":[{"award-number":["TTU 06.715_00"]}],"id":[{"id":"10.13039\/100009139","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Helicobacter pylori<\/jats:italic> antibiotic resistance is the most relevant cause of treatment failure. Antibiotic susceptibility testing (AST) allows for selecting the appropriate eradication regimen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess the diagnostic accuracy of gastric aspirate\u2010based genotypic AST (G\u2010AST) for detecting clarithromycin and levofloxacin resistance compared with conventional phenotypic AST (P\u2010AST).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We recruited 461 consecutive patients scheduled for endoscopy. <jats:italic>H. pylori<\/jats:italic> was detected intraprocedurally using Endofaster, a novel method combining endoscopy with gastric juice analysis. For <jats:italic>H. pylori<\/jats:italic>\u2010positive patients, we collected gastric aspirates and biopsies. G\u2010AST was performed using DNA extracted from aspirates, with Sanger sequencing to detect polymorphisms in the 23S rRNA and <jats:italic>gyrA<\/jats:italic> genes associated, respectively, with resistance to macrolides and fluoroquinolones. P\u2010AST was performed on <jats:italic>H. pylori<\/jats:italic> isolated from biopsies using ETEST.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and seventy\u2010eight (40.4%) patients tested positive for <jats:italic>H. pylori<\/jats:italic> during endoscopy. Paired gastric biopsies and aspirates were available from 152 <jats:italic>H. pylori<\/jats:italic>\u2010positive patients. By P\u2010AST, resistance rates were 15.1% (23\/152) for clarithromycin and 18.4% (28\/152) for levofloxacin. G\u2010AST showed a high level of agreement with P\u2010AST for clarithromycin (kappa 0.86) and levofloxacin (kappa 0.81) resistance and diagnostic accuracy of 97% and 95%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The novel method combining endoscopy with immediate intraprocedural gastric juice analysis for the detection of <jats:italic>H. pylori<\/jats:italic>, followed by AST in case of a positive finding, is valid and practical for tailoring eradication regimens for <jats:italic>H. pylori<\/jats:italic> infection. Genotypic AST from gastric aspirates is highly accurate for detecting clarithromycin and levofloxacin resistances.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.18378","type":"journal-article","created":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T10:11:20Z","timestamp":1731406280000},"page":"465-471","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Real\u2010Time Assessment of <i>H. pylori<\/i> Infection to Guide Molecular Antibiotic Resistance Testing: A Combined Endoscopy\u2010Gastric Juice Analysis Approach"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7150-5864","authenticated-orcid":false,"given":"Riccardo","family":"Vasapolli","sequence":"first","affiliation":[{"name":"Department of Medicine II University Hospital LMU Munich  Munich Germany"},{"name":"DZIF Deutsches Zentrum f\u00fcr Infektionsforschung Partner Site Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florent","family":"Ailloud","sequence":"additional","affiliation":[{"name":"DZIF Deutsches Zentrum f\u00fcr Infektionsforschung Partner Site Munich  Munich Germany"},{"name":"Max von Pettenkofer Institute, Faculty of Medicine Ludwig Maximilians University of Munich  Munich Germany"},{"name":"National Reference Center for Helicobacter Pylori  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beate","family":"Spie\u00dfberger","sequence":"additional","affiliation":[{"name":"Max von Pettenkofer Institute, Faculty of Medicine Ludwig Maximilians University of Munich  Munich Germany"},{"name":"National Reference Center for Helicobacter Pylori  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8439-9036","authenticated-orcid":false,"given":"Peter","family":"Malfertheiner","sequence":"additional","affiliation":[{"name":"Department of Medicine II University Hospital LMU Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Suerbaum","sequence":"additional","affiliation":[{"name":"DZIF Deutsches Zentrum f\u00fcr Infektionsforschung Partner Site Munich  Munich Germany"},{"name":"Max von Pettenkofer Institute, Faculty of Medicine Ludwig Maximilians University of Munich  Munich Germany"},{"name":"National Reference Center for Helicobacter Pylori  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schulz","sequence":"additional","affiliation":[{"name":"Department of Medicine II University Hospital LMU Munich  Munich Germany"},{"name":"DZIF Deutsches Zentrum f\u00fcr Infektionsforschung Partner Site Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-023-00431-8"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2022-327745"},{"issue":"4","key":"e_1_2_9_4_1","first-page":"646","article-title":"Effectiveness of Helicobacter pylori Treatments According to Antibiotic Resistance","volume":"119","author":"Bujanda L.","year":"2024","journal-title":"American Journal of Gastroenterology"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00384-3"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001659"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-021-00449-x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(23)00097-3"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12467"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v29.i10.1638"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199610000-00001"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101746.2007.04919.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.596371"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.5152\/tjg.2020.20025"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2021-324032"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(94)70067-2"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2022.02.027"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v30.i2.184"}],"container-title":["Alimentary Pharmacology &amp; 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