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Journal of Clinical Microbiology, April 2001, p. 1319-1322, Vol. 39, No. 4
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.4.1319-1322.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

cagA Status and Eradication Treatment Outcome of Anti-Helicobacter pylori Triple Therapies in Patients with Nonulcer Dyspepsia

Nathalie Broutet,^1,* Armelle Marais,¹ Hervé Lamouliatte,² Antoine de Mascarel,³ Roland Samoyeau,⁴ Roger Salamon,⁵ and Francis Mégraud¹

Laboratoire de Bactériologie,¹ and INSERM U330,⁵ Université Victor Segalen Bordeaux 2, and Service d'Hépato-Gastroentérologie, Hôpital St André,² Bordeaux, Service d'Anatomie Pathologique, Hôpital du Haut Lévêque, Pessac,³ and Laboratoires Byk-Gulden, Le Mée sur Seine,⁴ France

Received 9 November 2000/Returned for modification 4 January 2001/Accepted 22 January 2001

The differences in eradication rates reported in clinical trials aiming to cure Helicobacter pylori infection cannot be entirely explained by the type of regimen, bacterial resistance, or lack of compliance. Using data from a clinical trial, a logistic regression model was constructed to determine whether cagA status, assessed by PCR, affects the outcome of eradication. Resistance to clarithromycin (10% of the strains) predicted failure perfectly. In the model (n = 156), a cagA-lacking strain (odds ratio [OR] = 2.2; 95% confidence interval [CI], (1.1 to 4.7), tobacco smoking OR = 3.1; 95% CI, 1.3 to 7.0), and a double dose of proton pump inhibitor in the treatment regimen (OR = 0.3; 95% CI, 0.2 to 0.7) were associated with the treatment outcome. The exact role of cagA in the outcome of H. pylori eradication therapy has not been explored. However, the type of histological lesions which it causes in the gastric mucosa may be implicated. Regardless of the mechanism involved, cagA status is a good predictive marker of eradication outcome.

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^* Corresponding author. Mailing address: Unité d'Epidémiologie des Infections Digestives, BP 76, Laboratoire de Bactériologie, Université Victor Segalen Bordeaux 2, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France. Phone: 33-5 57 57 1119. Fax: 33-5 56 51 4182. E-mail: nathalie.broutet{at}labhel.u-bordeaux2.fr.

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Journal of Clinical Microbiology, April 2001, p. 1319-1322, Vol. 39, No. 4
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.4.1319-1322.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

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