Molecular-genetic studies in the diagnosis of Helicobacter pylori infection

The issues of optimizing the management of patients infected with Helicobacter pylori have remained relevant in clinical therapy and gastroenterology for many years. This is due both to the high prevalence of H. pylori infection in Russia: depending on the region, it is 35–60 %, and to the potential carcinogenicity of the microorganism in relation to the development of stomach cancer. According to clinical recommendations, when conducting an endoscopic examination of the upper gastrointestinal tract, a rapid urease test with a biopsy from the antrum and the body of the stomach or polymerase chain reaction (PCR) with a biopsy of the stomach may be recommended as a method of primary diagnosis of infection. Enhanced molecular genetic typing of the microbe can increase the effectiveness of diagnosis, with the identification of several genes encoding the synthesis of pathogenicity factors H. pylori, as well as the analysis of microbial resistance to antibiotics (detection of genes encoding mutations associated with microbial resistance). Thanks to a set of studies that include not only verification of the pathogen, but also molecular genetic typing of infection by PCR, it is possible to significantly optimize the management tactics of patients infected with H. pylori and provide a personalized approach to antihelicobacter therapy depending on the virulence and resistance of the strain of the pathogen with which a person is infected. The relevance and breadth of the use of full-genome H. pylori sequencing is increasing, however, this study is not used in routine medical practice, including due to the high cost.

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