Diagnostic Performance of Gastric Imprint Smear for Determination ofHelicobacter pyloriInfection

BACKGROUND: Despite the availability of several methods (invasive and noninvasive) for the diagnosis ofHelicobacter pyloriinfection, no test is considered to be the ‘gold standard’. Endoscopy-based tests are regarded as the reference method in most studies.OBJECTIVE: To evaluate the diagnostic performance of imprint cytology smears of antral biopsies compared with Gram-stained smears, the rapid urease test and culture methods, separately and in combination.METHODS: Antral biopsies were obtained from consecutive patients undergoing upper gastrointestinal endoscopy at a single centre. The biopsies were examined for the presence ofH pyloriby Gram-stained smear, the rapid urease test, culture methods and imprint cytology smear.RESULTS: A total of 273 biopsies were studied. All tests were positive in 36% of the patients. Of 252 biopsies tested, 73% were positive using the imprint cytology technique. Using Gram-stained smear, the rapid urease test and culture methods individually, the sensitivity and specificity of imprint cytology smears for the detection ofH pyloriwere found to be 92.7% and 50%; 92.7% and 49%; and 92.4% and 38.5%, respectively. Combining the three microbiological methods resulted in a sensitivity of 92.1%, a specificity of 51.0% and an efficiency of 71.7% for imprint cytology smears.CONCLUSIONS: Endoscopic examination provides useful clinical information. Imprint gastric cytology can be used as a rapid test to establish the diagnosis ofH pyloriinfection at the time endoscopy is performed, enabling the endoscopist to start treatment with immediate effect.

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Trends in Primary Antibiotic Resistance in H. pylori Strains Isolated in Italy between 2009 and 2019

Antibiotics ◽

10.3390/antibiotics9010026 ◽

2020 ◽

Vol 9 (1) ◽

pp. 26 ◽

Cited By ~ 3

Author(s):

Ilaria Maria Saracino ◽

Giulia Fiorini ◽

Angelo Zullo ◽

Matteo Pavoni ◽

Laura Saccomanno ◽

...

Keyword(s):

Antibiotic Resistance ◽

Reference Method ◽

Susceptibility Test ◽

Upper Gastrointestinal Endoscopy ◽

Rapid Urease Test ◽

Multiple Biopsies ◽

Antibiotic Susceptibility Test ◽

Urease Test ◽

H Pylori ◽

Resistance Rates

Background and aims: the increasing prevalence of strains resistant to antimicrobial agents is a critical issue for the management of Helicobacter pylori infection. This study aimed to evaluate, in Italian naïve patients, H. pylori antibiotic resistance trends and their potential predictive factors during the last decade. Methods: consecutive Italian naïve H. pylori positive patients, referred from General Practitioners to our Unit from January 2009 to January 2019 to perform an upper gastrointestinal endoscopy (UGIE), were considered. Each patient underwent 13C-urea breath test (13C-UBT) and UGIE with multiple biopsies to perform rapid urease test (RUT), culture/susceptibility test (vs. clarithromycin, metronidazole, levofloxacin), and histopathological examination. H. pylori status was assessed through CRM (composite reference method: at least two tests positive or only culture positive). Results: between 2009 and 2014, 1763 patients were diagnosed as H. pylori positive, 907 were naïve with antibiogram available. Between 2015 and 2019, 1415 patients were diagnosed as H. pylori positive, antibiotic susceptibility test was available in 739 naïve patients. H. pylori primary antibiotic resistance rates in the first and second five-year period were, respectively, clarithromycin 30.2% (95% CI 27.2–33.3), 37.8% (95% CI 34.2–41.4); metronidazole 33.3% (95% CI 30.2–36.5), 33.6% (95% CI 30.2–37.1); levofloxacin 25.6% (95% CI 22.8–28.5), 33.8% (95% CI 37.4–47.4), double resistance clarithromycin-metronidazole 18.9% (95% CI 16.4–21.6), 20.7% (95% CI 17.8–23.8). The increase of the resistance rates to clarithromycin and levofloxacin in naïve patients was statistically significant (p < 0.05). Although eradication rates for sequential therapy in the 10 years considered were 93.4% (95% CI 92–94.6) and 87.5% (95% CI 85.7–89) at per-protocol (PP) and intention-to-treat (ITT) analysis, respectively, they showed a significant decrease in the second five-year period. Conclusions: this data highlights an increase in primary H. pylori antibiotic resistance and strongly suggests the importance of drug susceptibility testing also in naïve patients.

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GENDER, AGE, ENDOSCOPIC FINDINGS, UREASE AND HELICOBACTER PYLORI: ALL UNCORRELATED WITHIN A SAMPLE OF A HIGH GASTRIC CANCER PREVALENCE POPULATION IN AMAZON

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201900000-50 ◽

2019 ◽

Vol 56 (3) ◽

pp. 264-269

Author(s):

Ariney Costa de MIRANDA ◽

Cássio CALDATO ◽

Mira Nabil SAID ◽

Caio de Souza LEVY ◽

Claudio Eduardo Corrêa TEIXEIRA ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Cross Sectional Study ◽

Upper Gastrointestinal Endoscopy ◽

Histopathological Analysis ◽

Rapid Urease Test ◽

Cross Sectional ◽

Cancer Prevalence ◽

Urease Test ◽

H Pylori

ABSTRACT BACKGROUND: It is widely assumed that gender, age, gastritis and Helicobacter pylori , all have some degree of correlation and, therefore, can synergistically lead to the development of gastric cancer. OBJECTIVE: In this cross-sectional study, we expected to observe the above mentioned correlation in the analysis of medical records of 67 patients of both sexes (female, n=44), mean age ± standard deviation: 41±12 years old, all from Belém (capital of Pará State, Brazilian Amazon), a city historically known as one with the highest gastric cancer prevalence in this country. METHODS: All patients were submitted to upper gastrointestinal endoscopy for gastric biopsy histopathological analysis and rapid urease test. All diagnoses of gastritis were recorded considering its topography, category and the degree of inflammatory activity, being associated or not associated with H. pylori infection. RESULTS: The results show that no statistically relevant associations were found among the prevalences of the observed variables. CONCLUSION: The authors hypothesize that observed risk factors associated to gastric cancer might be lesser synergistic than is usually expected.

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Helicobacter pylori culture as a key tool for diagnosis in Colombia

The Journal of Infection in Developing Countries ◽

10.3855/jidc.10720 ◽

2019 ◽

Vol 13 (08) ◽

pp. 720-726

Author(s):

Diana F Rojas-Rengifo ◽

Belen Mendoza ◽

Carlos Jaramillo ◽

Paula A Rodríguez-Urrego ◽

José F Vera-Chamorro ◽

...

Keyword(s):

Predictive Value ◽

Optimal Growth ◽

Rapid Urease Test ◽

Culture Methods ◽

Essential Information ◽

Urease Enzyme ◽

Urease Test ◽

Gastric Biopsies ◽

H Pylori ◽

Sensitivity Specificity

Introduction: The presence of H. pylori in the stomach is associated with gastric pathologies. However, its diagnosis through culture methods is challenging because of its complex nutritional requirements and microaerophilic conditions for optimal growth. The preferred method for rapid diagnosis of H. pylori is the Rapid Urease Test (RUT) from human biopsies, which relies on the high activity of the urease enzyme present in H. pylori. However, RUT cannot say much more information about H. pylori. This makes evident the need for bacterial culture to know essential information such as the strain type, the kind of infection present and the bacteria’s antibiotic susceptibility. Methodology: Gastric biopsies from 347 patients were used for H. pylori isolation. We correlated the culture results with the RUT and histological grading used at Hospital Universitario Fundación SantaFe de Bogotá (HU-FSFB), Colombia. The concordance between techniques was determined by the Cohen’s Kappa coefficient (K). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were also calculated. Results: The culture standardization was successful, and it could be applied for diagnosis in the clinical practice. H. pylori was positive by culture in 88 (26.34%) patients. The concordance of RUT and culture was strong (K= 0.805), and between histology and culture was moderate (K= 0.763) as well as for the gold standard defined and culture (K= 0.80). Conclusions: We present evidence that RUT and histological methods will be better interpreted for diagnosis of H. pylori if combined with bacterial isolation in cholesterol enriched culture.

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Helicobacter pylori infection in patients undergoing upper endoscopy at University Hospital in Uberaba, Minas Gerais, Brazil.

JMPHC | Journal of Management & Primary Health Care | ISSN 2179-6750 ◽

10.14295/jmphc.v4i1.164 ◽

2013 ◽

Vol 4 (1) ◽

pp. 33-35 ◽

Cited By ~ 1

Author(s):

Fernanda Machado Fonseca ◽

Renata Margarida Etchebehere ◽

Adriana Gonçalves Oliveira

Keyword(s):

Helicobacter Pylori ◽

Breath Test ◽

Histological Study ◽

Rapid Test ◽

University Hospital ◽

Rapid Urease Test ◽

Duodenal Ulcers ◽

Urease Test ◽

Significant Difference ◽

H Pylori

Helicobacter pylori is a Gram negative bacterium that cause chronic gastritis, duodenal ulcers and can predispose the gastric cancer. The study aimed to determinate the prevalence of H. pylori infection by different methods of diagnosis in patients submitted to endoscopy. Of the 145 patients included in the study, were collected fragments of gastric mucosa for histological analysis, and for the rapid urease test. The breath test was also performed. The H. pylori infection was detected in 84 (57.9%) patients by histological study, the rapid test of urease was positive in 81 (55,8%) and the breath test in 62 (56,3%). There was no statistically significant difference when comparing the prevalence of infection by different methods of diagnosis. The prevalence of H. pylori infection in our community was lower than that found in the literature for patients with age similar to this study (mean = 53.19 years).

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A new understanding of the H. pylori eradication mechanism

10.21203/rs.2.15795/v1 ◽

2019 ◽

Author(s):

Shanshan Su ◽

Guo-qi Zheng ◽

Ying-ying Liu ◽

Yu-fei Liang ◽

Hui Song ◽

...

Keyword(s):

Gastric Juice ◽

Intervention Group ◽

Control Group ◽

Rapid Urease Test ◽

Mucus Layer ◽

Culture Methods ◽

Detection Rates ◽

Urease Test ◽

Gastric Lumen ◽

H Pylori

Abstract Background: Helicobacter pylori (H. pylori) cannot usually be detected in the gastric juice and it is thought that H. pylori may be implanted under the mucus layer for long term. The mechanisms of action of proton pump inhibitor (PPI), antibiotics, and bismuth for H. pylori eradication are not entirely clear. Our study aimed to determine the role of PPI on the movement of H. pylori across the mucus layer to the gastric lumen and the mechanism of PPI, antibiotics, and bismuth on H. pylori eradication. Methods: Patients with H. pylori infection were intravenous injected with PPI (intervention group, n=31) or without PPI (control group, n=37). The presence of H. pylori in the gastric juice was evaluated by the rapid urease test (RUT), polymerase chain reaction (PCR), and culture methods. Results: The H. pylori positive detection rates were all significantly higher among patients in the intervention group than among patients in the control group by the RUT (P < 0.0001), PCR (P < 0.0001), and culturing (P = 0.0386). Conclusion: H. pylori can penetrate across the mucus layer to the gastric lumen following PPI intervention. The direct antimicrobial activity of PPI might because of diminished numbers of H. pylori due to probiotics in the gastric lumen. Antibiotics and bismuth might play a local sterilization role in the gastric lumen when H. pylori penetrate across the mucus layer.

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Prospective study to evaluate the number and the location of biopsies in rapid urease test for diagnosis of Helicobacter Pylori

Gastroenterology Insights ◽

10.4081/gi.2017.7223 ◽

2017 ◽

Vol 8 (1) ◽

Author(s):

Antoine Abou Rached ◽

Jowana Saba ◽

Cesar Yaghi ◽

Joyce Sanyour ◽

Ahmad El Hajjar ◽

...

Keyword(s):

Helicobacter Pylori ◽

Sensitivity And Specificity ◽

Predictive Value ◽

Rapid Test ◽

Rapid Urease Test ◽

Ulcer Disease ◽

Urease Test ◽

Gastric Biopsies ◽

H Pylori ◽

Antral Biopsy

Helicobacter pylori (H. pylori) can cause a wide variety of illnesses such as peptic ulcer disease, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. The diagnosis and eradication of H. pylori are crucial. The diagnosis of H. pylori is usually based on the rapid urease test (RUT) and gastric antral biopsy for histology. The aim of this study is to evaluate the numbers of needed biopsies and their location (antrum/fundus) to obtain optimal result for the diagnosis of H. pylori. Three hundred fifty consecutive patients were recruited, 210 fulfill the inclusion criteria and had nine gastric biopsies for the detection of H. pylori infection: two antral for the first RUT (RUT1), one antral and one fundic for the second (RUT2), one antral for the third (RUT3) and two antral with two fundic for histology (HES, Giemsa, PAS). The reading of the 3 types of RUT was performed at 1 hour, 3 hours and 24 hours and biopsies were read by two experienced pathologists not informed about the result of RUT. Results of RUT were considered positive if H. pylori was found on histology of at least one biopsy. The RUT1 at 1h, 3h and 24h has a sensitivity of 72%, 82% and 89% and a specificity of 100%, 99% and 87% respectively. The positive predictive value (PPV) was 100%, 99% and 85% respectively and the negative predictive value (NPV) of 81%, 87% and 90%. The RUT2 at 1h, 3h and 24h, respectively, had a sensitivity of 86%, 87% and 91% and a specificity of 99%, 97% and 90%. The PPV was 99%, 96% and 88% and NPV of 89%, 90%, 94%. The RUT3 at 1h, 3h and 24h, respectively, had a sensitivity of 70%, 74% and 84% and a specificity of 99%, 99% and 94%. The PPV was 99%, 99% and 92% and NPV of 79%, 81% and 87%. The best sensitivity and specificity were obtained for RUT1 read at 3h, for RUT2 read 1h and 3h, and the RUT3 read at 24h.This study demonstrates that the best sensitivity and specificity of rapid test for urease is obtained when fundic plus antral biopsy specimens are used with a reading time at 3 hours.

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Antibiotic resistance of Helicobacter pylori in Mongolia

The Journal of Infection in Developing Countries ◽

10.3855/jidc.8619 ◽

2017 ◽

Vol 11 (11) ◽

pp. 887-894 ◽

Cited By ~ 5

Author(s):

Mandkhai Bolor-Erdene ◽

Bira Namdag ◽

Yoshio Yamaoka ◽

Sarantuya Jav

Keyword(s):

Helicobacter Pylori ◽

Antibiotic Resistance ◽

Antibiotic Sensitivity ◽

Upper Gastrointestinal Endoscopy ◽

Rapid Urease Test ◽

Treatment Regimens ◽

Urease Test ◽

H Pylori ◽

Strip Testing ◽

Resistance Rates

Introduction.The resistance of Helicobacter pylori to recently available antibiotic treatment regimens has been recognized as a growing problem. Therefore, the aim of this study was to determine the prevalence of antibiotic resistance among H. pylori strains isolated from Mongolians. Methodology. All gastric biopsy specimens were obtained during upper gastrointestinal endoscopy from patients referred for the exploration of dyspepsia. The urease positive samples by rapid urease test were cultured according to standard microbiological procedures and H. pylori were grown under microaerophilic conditions on selective Pylori agar. H. pylori antibiotic sensitivity was examined using E-test. In addition, the mutations of the corresponding gene were studied by GenoType HelicoDR DNA strip testing. Results. Three hundred twenty patients, 216 female and 104 male in the ages range of 18 to 83 years were included in this study. Rapid urease test yielded positive results for 65.9% (211/320). Among them, we have successfully obtained 72% H. pylori isolates. The antibiotic resistance rates were 35.5% for clarithromycin, 68.4% metronidazole, 23.0% amoxicillin, 25.0% tetracycline, 28.2% erythromycin and 14.5% nitrofuranton. Resistance for 2 drugs was 34.5% and that of 3 drugs was observed in 14.5% of isolates. The most prevalent mutation was A2147G followed by A2146G and D91Y. The prevalence of H. pylori infection increased among Mongolian population and the prevalence of resistance of H. pylori is very high to metronidazole, and moderate to clarithromycin. Conclusion. The data on antimicrobial susceptibilities provided by the present study is may assist the clinicians on the effectiveness of treatment regimens.

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Helicobacter pylori eradication in renal transplant candidates

Brazilian Journal of Nephrology ◽

10.1590/2175-8239-jbn-2021-0097 ◽

2022 ◽

Author(s):

Mariana E. Maioli ◽

Raquel F. N. Frange ◽

Cintia M. C. Grion ◽

Vinicius D. A. Delfino

Keyword(s):

Chronic Kidney Disease ◽

Helicobacter Pylori ◽

Gastrointestinal Endoscopy ◽

Eradication Rate ◽

Upper Gastrointestinal Endoscopy ◽

Rapid Urease Test ◽

Urease Test ◽

Transplant Candidates ◽

H Pylori ◽

Upper Gastrointestinal

Abstract Introduction: Treatment for Helicobacter pylori (H. pylori) infection is recommended in transplant candidates due to the association between this infection and gastrointestinal disorders, which could significantly increase morbidity after renal transplantation with the use of immunosuppression. The objective of this study was to analyze the rate of eradication of H. pylori after antimicrobial treatment in chronic kidney disease patients who are candidates for kidney transplantation. Methods: A multicenter prospective cohort study was conducted. All adult chronic kidney disease patients seen at our institution were included. In the pre-transplantation evaluation, 83 patients underwent an upper gastrointestinal endoscopy with 2 diagnostic methods to detect H. pylori: histology and the rapid urease test. In total, 33 patients with H. pylori infection received treatment with 20 mg omeprazole, 500 mg amoxicillin, and 500 mg clarithromycin once daily for 14 days. Another upper gastrointestinal endoscopy was performed 8 to 12 weeks after the end of treatment to check for healing. Results: The study showed a prevalence of H. pylori in 51 (61.4%) patients. Histology was positive in 50 (98%) patients and the rapid urease test was positive in 31 (60.8%). The infection eradication rate was 48.5% (16 patients). Conclusions: There was a high prevalence rate of H. pylori and a low eradication rate after the long-term antimicrobial triple scheme used. The association of the rapid urease test with gastric mucosa histology did not increase the detection rate of H. pylori.

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Prevalence of Helicobacter Pylori Infection in Patients with Portal Hypertension

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v6i2.22470 ◽

2018 ◽

Vol 6 (2) ◽

pp. 16-19

Author(s):

Shatdal Chaudhary ◽

Altaban Rahi ◽

Anita Shah ◽

Aakash Shahi ◽

Badri Kumar Gupta ◽

...

Keyword(s):

Helicobacter Pylori ◽

Portal Hypertension ◽

Upper Gastrointestinal Endoscopy ◽

Rapid Urease Test ◽

World Population ◽

Gastric Erosion ◽

Inclusion Criteria ◽

Urease Test ◽

Study Population ◽

H Pylori

Introduction: Helicobacter pylori (H. pylori) is a microaerophile gram-negative bacillus which is found mainly on the surface of mucous membrane of the prepyloric part of the stomach. It is found to be infecting approximately 50% of world population. In patients with liver cirrhosis, the prevalence of H. pylori is variable. A high incidence of H. pylori colonization has been found in portal hypertension; especially in those with gastric erosion. This study was done to find out the prevalence of H. pylori infection in patients with portal hypertension at Universal College of Medical Sciences Teaching Hospital, Nepal. Materials and methods: It was a hospital based cross sectional observational study. All the consecutive patients aged more than 16 years, presented with portal hypertension who fulfilled the inclusion criteria were included in the study. The study period was from 1st September 2015 to 31st August 2016. The upper gastrointestinal endoscopy was done in all cases and mucosal biopsy was taken. H. pylori infection was diagnosed by using rapid urease test. Results: During the study period, 71 patients fulfilled the inclusion criteria and were included in the analysis. The majority of the patients 21 (29.6%) were between 51-60 years age group. There were more male (78.9%) then female (21.1%). The mean age of study population was 50.85 ± 12.47 years. Among the study population, rapid urease test was positive in 70.4% (n=50) patients. Conclusion: The prevalence of H. pylori infection was seen in 70.4% of the patients suffering with portal hypertension.

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Performance of RoutineHelicobacter pyloriInvasive Tests in Patients with Dyspepsia

Gastroenterology Research and Practice ◽

10.1155/2013/184806 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Hsi-Chang Lee ◽

Ting-Chang Huang ◽

Chin-Lin Lin ◽

Kuan-Yang Chen ◽

Chung-Kwe Wang ◽

...

Keyword(s):

Predictive Value ◽

Gastrointestinal Endoscopy ◽

Positive Culture ◽

Upper Gastrointestinal Endoscopy ◽

Rapid Urease Test ◽

Urease Test ◽

H Pylori ◽

Sensitivity Specificity ◽

Upper Gastrointestinal ◽

Antral Biopsy

Background. This study was designed to compare the accuracy of three different invasive methods for the detection ofHelicobacter pylori (H. pylori)infection in patients with dyspepsia. These tests included culture, histology, and the rapid urease test (CLO test).Methods.H. pyloriinfection was diagnosed prospectively in 246 untreated dyspeptic patients who underwent upper gastrointestinal endoscopy. The gold standard forH. pyloriinfection was based on a positive culture or both a positive histological examination and a CLO test.Results.H. pyloriwas diagnosed in 33.3% of the patients. The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were as follows: histology from the antrum (95.12; 95.12; 90.7; 97.5; 95.12%); histology from the antrum and corpus (95.12; 95.12; 90.7; 97.5; 95.12%); histology from the corpus (76.83; 96.95; 92.65; 89.33; 90.24%); culture (91.46; 100; 100; 95.91; 97.15%); a CLO test from the antrum and corpus (85.59; 100; 100; 93.71; 95.52%); a CLO test from the antrum (64.63; 100; 100; 84.97; 88.21%); a CLO test from the corpus (69.51; 100; 100; 96.77; 89.83%), respectively.Conclusions. Antral biopsy histology and culture are the best methods for the diagnosis ofH. pyloriinfection in our cohort of patients with dyspepsia.

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