MICROBIOLOGY
Combating AMR: advanced diagnostics and resistance profiling for H. pylori
The bacterium Helicobacter pylori is a key contributor to antimicrobial resistance. Here, Lynden Rooms examines the advantages offered by novel molecular diagnostics over current options, including improvements in antimicrobial stewardship.
Antimicrobial resistance (AMR) continues to pose a significant global health challenge, affecting treatment outcomes for a wide range of infections. In 2024, the UK government released Confronting antimicrobial resistance 2024 to 2029, the second iteration of its five-year AMR action plan, aiming to reduce the AMR burden by improving
antibiotic stewardship, enhancing infection prevention measures, and driving innovation in diagnostics and treatments. Key goals include achieving a 15% reduction in inappropriate antibiotic prescriptions, emphasising the need to improve diagnostic precision and reduce reliance on broad-spectrum antibiotics.1 While these goals are ambitious, the
government has allocated significant funding to support their achievement, with over £200 million earmarked for AMR-related initiatives, including the development of diagnostic tools and stewardship programmes.2
One of the main focuses of the plan is the ‘development and implementation of diagnostics that enable the targeted use of antimicrobials and reduce unnecessary prescribing’. This highlights the crucial role that diagnostics play in ensuring effective antibiotic use and mitigating resistance. This shift from empiric prescribing to evidence-based precision medicine, strongly advocated by the AMR action plan, plays a pivotal role in enabling better treatment outcomes and curbing the rise of resistant strains through the provision of timely, accurate and actionable diagnostic data. Among the pathogens contributing to the AMR crisis is Helicobacter pylori, a bacterium associated with serious gastric conditions, such as gastric cancer. Addressing H. pylori resistance, particularly to clarithromycin, requires advanced diagnostic solutions to ensure effective and targeted treatments.
H. pylori resistance H. pylori is a spiral-shaped, Gram- negative bacterium that colonises the gastric mucosa. Whilst not commensal, it is believed to infect roughly half of the world’s population.3
It is transmitted
primarily via the oral-oral or faecal- oral route, with poor sanitation and overcrowding being significant risk factors for transmission.4
Once established in the
Once established in the stomach lining, H. pylori can persist for decades due to its ability to evade the immune response and adapt to the acidic gastric environment.
WWW.PATHOLOGYINPRACTICE.COM MAY 2025
stomach lining, H. pylori can persist for decades due to its ability to evade the immune response and adapt to the acidic gastric environment through mechanisms such as urease production, which neutralises stomach acid by converting
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