{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:28:10Z","timestamp":1788449290322,"version":"build-2803163510"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Growing antibiotic resistance in <jats:italic>Helicobacter pylori<\/jats:italic> (<jats:italic>H. pylori<\/jats:italic>) diminishes eradication therapy effectiveness, emphasizing the need for accurate, non-invasive diagnostic techniques. This study aims to assess the clinical utility of PCR analysis of fecal samples for detecting antibiotic resistance in guiding personalized treatment for <jats:italic>H. pylori<\/jats:italic> infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective, observational study was conducted across 13 hospitals within Jiangsu Province. Fecal samples were analyzed using fluorescence PCR for the <jats:italic>23S rRNA<\/jats:italic> and <jats:italic>gyrA<\/jats:italic> genes, indicating clarithromycin and levofloxacin resistance. Then, individualized eradication recommendations were proposed for the <jats:italic>H. pylori<\/jats:italic>-positive patients. A follow-up was performed one year later to evaluate the eradication outcomes in a routine medical environment, with participants having provided informed consent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 387 participants completed the eradication treatment, with an overall success rate of 91.0% (352\/387, 95% CI: 87.6%-93.6%). Among them, 310 individuals received a 14-day course of bismuth quadruple therapy (BQT), achieving an eradication rate of 90.0% (279\/310, 95% CI: 86.1%-93.1%). 77 participants were treated with high-dose dual therapy (HDDT) for the same duration, resulting in a slightly higher eradication rate of 94.8% (73\/77, 95% CI: 87.2%-98.6%), although this difference was not statistically significant (<jats:italic>P<\/jats:italic>=0.188). No significant differences in eradication rates were observed among various BQT antibiotic combinations (<jats:italic>P<\/jats:italic>=0.208). The eradication rates for HDDT, based on either vonoprazan or esomeprazole, were 96.8% (61\/63, 95% CI: 89.0%-99.6%) and 85.7% (12\/14, 95% CI: 57.2%-98.2%), respectively, without a significant difference (<jats:italic>P<\/jats:italic>=0.304).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PCR detection from fecal samples targeting the resistance genes of <jats:italic>H. pylori<\/jats:italic> is effective in guiding personalized treatments, highlighting its clinical utility and potential for broader application.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2025.1519804","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T05:29:55Z","timestamp":1745818195000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical evaluation of personalized Helicobacter pylori treatment guided by PCR detection from fecal samples: a real-world study"],"prefix":"10.3389","volume":"15","author":[{"given":"Ruolin","family":"Peng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhimei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuchu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengyuan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiabin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujun","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meijuan","family":"Xi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Zhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijia","family":"Din","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Ou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gongyu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangxia","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxin","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamei","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenyu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2400","DOI":"10.1128\/JCM.00506-17","article-title":"A novel stool pcr test for helicobacter pylori may predict clarithromycin resistance and eradication of infection at a high rate","volume":"55","author":"Beckman","year":"2017","journal-title":"J. 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