A191 EFFICIENCY OF TAILORED ERADICATION REGIMEN BASED ON ANTIBIOTIC SUSCEPTIBILITY AND CYP2C19 GENOTYPE TESTING IN CHILDREN WITH REFRACTORY HELICOBACTER PYLORI INFECTION
Notice bibliographique
Résumé
Abstract Background Refractory helicobacter pylori (Hp) is a challenging problem for pediatric population. Whether Hp culture and CYP2C19 genotype need to be done together still remains contraversial. Aims To explore the efficiency of tailored eradication therapy based on helicobacter pylori culture, susceptibility and CYP2C19 genotype in children who failed to empirical Hp eradication strategy in Baoding region(China). Methods This study is an observational cohort study. A total of 156 children with Hp infection who failed to amoxicillin + clarithromycin +omeprazole triple regimen in Baoding Children’s Hospital were selected as study subjects, and 92 of them underwent Hp culture and CYP2C19 genetic testing. 75 cases with successful Hp culture were defined as successful culture group and were treated according to antibiotics sensitivity and genotype results. 17 cases with failed culture were defined as culture failure group and were treated only based on the results of CYP2C19 genotype. 64 children who did not agree to perform Hp culture and CYP2C19 gene testing were defined as the empirical eradication therapy group and were treated with quadruple therapy (amoxicillin + metronidazole + omeprazole + bismuth). Antibiotics resistance, CYP2C19 gene polymorphism and therapeutic efficiency between the three groups were compared and analyzed. Results Results of Hp culture and antibiotics susceptibility: among the 75 children with successful culture, 72 (96%) were resistant to clarithromycin, 3 (4%) were resistant to metronidazole, 5 (7%) were resistant to levofloxacin, 5 (7%) were resistant to rifampicin, 1 (1%) was resistant to tetracycline, and there was no resistance to amoxicillin and furazolidone. Results of CYP2C19 genotype test: among the 92 patients who underwent genotype test, 43 were Extensive Metabolizer (EM) (47%), 9 were Poor Metabolizer (PM) (10%), and 40 were Intermediate Metabolizer (IM) (44%). Efficiency results: eradication rate in the successful culture group, culture failure group and empirical eradication therapy group was 99% (74/75),88%(15/17) and 72%(46/64), respectively. The eradication rate of children in the culture failure group and the empirical eradication therapy group were both lower than that in the successful culture group,and there were no difference between empirical eradication therapy group and culture failure group(p=0.283). Conclusions Tailored treatment based on Hp culture + antibiotics susceptibility and CYP2C19 genotype detection should be performed in children with refractory Hp infection. Hp culture + antibiotics susceptibility plays a more important role than CYP2C19 genotype. Funding Agencies None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».