Cover story for Pulse@UM Year 2020 Issue 3: Health at the crossroads – An interdisciplinary approach

Helicobacter pylori Eradication: A Frontier Digital Health System for Treatment Management via Antibiotic Resistance Profiles

By Prof. Chua Kek Heng

Helicobacter pylori is a bacterium that has quietly lived in the gut of nearly two-thirds of the world population, however many people are asymptomatic. Having this bacterium, a silent killer, living in the human body can lead to stomach ulcers and further increase the risk of developing stomach cancer up to six times higher compared to an uninfected individual. In the early 1990s, H. pylori was successfully eradicated in nearly 90 percent of the cases using 7-day first-line antibiotics. However, it has now become a challenging infection to treat as this bacterium has changed and resists the killing effects of commonly used antibiotics. Hence, to develop a more effective treatment regimen for H. pylori infection, it is crucial to gain insights into the antibiotic resistance profiles of the bacterium.

The assessment of antibiotic resistance profiles in clinical settings often involves the cultivation of bacteria from infected patients, which requires a longer turnaround time for results.  However, H. pylori is hard to be grown in a laboratory; therefore, in vitro cultivation is not a wise approach to track the infection. In this cross-disciplinary collaborative project, we aim to study the changes of bacterium’s genetic materials related to drugs commonly used in local clinical practice, especially clarithromycin against H. pylori using extracted DNA from biopsy samples. This could directly guide the researchers or medical personnel to identify an appropriate drug to eliminate and control the growth of H. pylori in the human body while bypassing the bacterial cultivation step. 

Overall workflow – integration of different disciplines towards the development of antibiotic resistance profiles in H. pylori.

The antibiotic resistance profiles obtained from this research will further be utilized to establish a molecular screening panel for use in the local community. The information generated from the screening panel will be subsequently subjected to suitable ruled-based methods, e.g. what-if models to suggest appropriate drug treatment. The output of this project certainly will benefit physicians in decision-making as well as patients to ensure they receive the effective antibiotic for treatment. 

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