Helicobacter pylori infection : in vitro diagnostic methods, antimicrobial susceptibility testing, epidemiology of recrudescence and clarithromycin resistance

Abstract

H. pylori is a Gram-negative, non-spore forming, curved bacterium that colonises the gastric epithelium of the human stomach. H. pylori is firmly established as an aetiological agent in peptic ulcer disease and successful eradication of this organism leads to duodenal ulcer cure. Culture of selected biopsy specimens that are known to be presumptively positive for H. pylori by a urease test might generate both accurate and cost-effective protocols for the diagnosis of this infection in clinical practice. Hence, the feasibility of culturing H. pylori from antral biopsy specimens of positive CLOtests was assessed. H. pylori was cultured from routine antral biopsy specimens in 34 of 38 (89%) H. pylori-infected patients and from antral biopsy specimens from positive CLOtests in 30 (79%) of these patients. Therefore, optimal isolation rates were achieved with routine biopsies. From a practical view point, it may be more reliable to store the routine microbiology biopsy at 4°C until the CLO test yields a positive result before sending the routine biopsy for culture.