{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T20:52:38Z","timestamp":1775249558389,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["24\/848"],"award-info":[{"award-number":["24\/848"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Helicobacter pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      (\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>H. pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      ) infection is a major cause of peptic ulcer disease and gastric cancer. Rising clarithromycin resistance has significantly reduced the efficacy of standard triple therapy. In Aotearoa New Zealand, the prevalence and impact of antibiotic resistance remain incompletely defined, limiting the development of effective treatment strategies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Aims<\/jats:title>\n                    <jats:p>\n                      This study evaluated the feasibility and clinical utility of detecting clarithromycin resistance genes using droplet digital polymerase chain reaction (ddPCR) on stored Rapid Urease Test (RUT) samples\u2014a relatively novel application of molecular diagnostics. We also assessed the association between resistance status and treatment outcomes following empiric first\u2010line triple therapy. Patients with positive RUT tests during gastroscopy were treated with omeprazole\u2010based triple therapy and followed up with\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>H. pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      stool antigen testing to confirm eradication.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 84 patients, clarithromycin resistance genes were detected in 13 (15.5%). Overall eradication was achieved in 74 (88.1%) patients. However, eradication success was significantly lower in those with resistance (38.5%) compared to those without (97.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Infection burden, treatment regimen, and duration were not associated with eradication rates, supporting resistance status as the primary determinant of treatment outcome. Resistance rates were similar between M\u0101ori and Pacific patients (18.2%) and other ethnic groups (14.8%), although sample sizes limited definitive conclusions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ddPCR testing on stored RUT samples is a feasible and effective method for detecting clarithromycin resistance. This study demonstrates that clarithromycin resistance, rather than infection burden, treatment regimen, or duration, drives eradication failure in New Zealand. Tailored therapy based on molecular resistance testing may enhance treatment success and support antibiotic stewardship. These findings justify the development of PCR\u2010guided treatment pathways and provide a strong rationale for extending this approach to non\u2010invasive stool\u2010based testing suitable for use in primary care and screening programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hel.70075","type":"journal-article","created":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T06:40:23Z","timestamp":1758955223000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Droplet Digital\n                    <scp>PCR<\/scp>\n                    \u2010Based Detection of Clarithromycin Resistance on Rapid Urease Test Samples Predicts\n                    <scp>\n                      <i>Helicobacter pylori<\/i>\n                    <\/scp>\n                    Eradication Success: A New Zealand Cohort Study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6559-743X","authenticated-orcid":false,"given":"Stephen James","family":"Inns","sequence":"first","affiliation":[{"name":"University of Otago  Wellington New Zealand"},{"name":"Capital Coast and Hutt Valley Health New Zealand Te Whatu Ora  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Sowerbutts","sequence":"additional","affiliation":[{"name":"University of Otago  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bibek","family":"Yumnam","sequence":"additional","affiliation":[{"name":"Malaghan Institute of Medical Research  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Payne","sequence":"additional","affiliation":[{"name":"Malaghan Institute of Medical Research  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgina","family":"Wheller","sequence":"additional","affiliation":[{"name":"Malaghan Institute of Medical Research  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mali","family":"Camberis","sequence":"additional","affiliation":[{"name":"Malaghan Institute of Medical Research  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3943-9198","authenticated-orcid":false,"given":"Thomas","family":"Mules","sequence":"additional","affiliation":[{"name":"University of Otago  Wellington New Zealand"},{"name":"Capital Coast and Hutt Valley Health New Zealand Te Whatu Ora  Wellington New Zealand"},{"name":"Malaghan Institute of Medical Research  Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"issue":"24","key":"e_1_2_12_2_1","first-page":"6735","article-title":"Human Gastric Carcinogenesis: A Multistep and Multifactorial Process\u2014First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention1","volume":"52","author":"Correa P.","year":"1992","journal-title":"Cancer Research"},{"key":"e_1_2_12_3_1","volume-title":"IARC Monographs on the Evaluation of Carcinogenic Risks to Humans","author":"International Agency for Research on Cancer","year":"1994"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.04.022"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102022\u2010327745"},{"issue":"1384","key":"e_1_2_12_6_1","first-page":"64","article-title":"Increasing Primary Antibiotic Resistance and Ethnic Differences in Eradication Rates of \n                     Helicobacter pylori\n                   Infection in New Zealand\u2014A New Look at an Old Enemy","volume":"126","author":"Hsiang J.","year":"2013","journal-title":"New Zealand Medical Journal"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/03036758.2019.1650081"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.4.1600\u20101603.2005"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.07.007"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1023\/a:1005457226341"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12804"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0265322"},{"key":"e_1_2_12_13_1","unstructured":"bpac \u201cH. pylori: Who to Test and How to Treat\u201d https:\/\/bpac.org.nz\/2022\/h\u2010pylori.aspx."},{"key":"e_1_2_12_14_1","unstructured":"S. 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