Review for 10.1186/s12876-020-01549-9 (2020)

Reviewer’s report
Title: 
Assessment of a novel method to detect clarithromycin-resistant
Helicobacter pylori using a stool antigen test reagent
Version: 
1 
Date: 
06 Aug 2020
Reviewer's report:
The authors tried to prove the validity and usefulness of the newly developed
nested PCR-QProbe method by the authors themselves to detect CAM-resistant
23S rRNA genetic mutations of H. pylori from the leftover fluid of stool antigen
test. They successfully demonstrated that the CAM resistance results of the
nested PCR-QProbe in 53 adolescents and 21 adults were consistent with the
results of direct sequencing of the PCR products and drug sensitivity tests,
respectively. The newly developed nested PCR-QProbe is a very useful and
practical non-invasive method to detect CAM-resistance in adolescents when
intending to eradicate H. pylori in the high prevalence area of CAM-resistant
strains.
However, the authors did treat CAM-resistant H. pylori-infected adolescent
patients with a 7-day vonoprazan-amoxicillin-CAM regimen. It is known that
CAM-resistant H. pylori strain is never to be affected at all by CAM. The
eradication rate of 82.6% in the CAM resistance mutation group might not be
easily understood. The authors should describe the plausible reasons for their
results.
The sentences of lines 3~5 on page 14 (Second, although we were able to
determine no difference in drug susceptibility test results among drugs used to
eradicate H. pylori, we were unable to assess the effect of differences in H.
pylori genotypes) need to be explained easily to convey meaning well to the
readers.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
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Yes
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Yes
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from apparent manipulation?
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