Abstract
Background Helicobacter pylori infection is most prevalent in developing countries. It is an etiological agent of peptic ulcer, gastric adenocarcinoma, and mucosal-associated lymphoid tissue (MALT) lymphoma. Despite the development of different assays to confirm H. pylori infection, the diagnosis of infection is challenged by precision of the applied assay. Hence, the aim of this study was to understand the diagnostic accuracy of PCR and microscopy to detect the H. pylori in the gastric antrum biopsy specimen from gastric disorder patients. Methods A total of 52 patients with gastric disorders underwent upper gastrointestinal endoscopy with biopsy. The H. pylori infection in gastric biopsies was identified after examination by microscopy and 23S rRNA specific PCR. The agreement between two test results were analysed by McNemar's test and Kappa coefficient. Result H. pylori infection was confirmed in 9 (17.30%) patients by both assays, 6.25% in antral gastritis, 22.22% in gastric ulcer, 100% in gastric ulcer with duodenitis, 50% in gastric ulcer with duodenal ulcer, and 33.33% in severe erosive duodenitis with antral gastritis. Out of nine H. pylori infection confirmed patients, 3 patients were confirmed by microscopy and 8 patients by PCR. In case of two patients, both microscopy and PCR assay confirmed the H. pylori infection. The agreement between two test results was 86.54% and disagreed by 13.46% (p value > 0.05). Conclusion We found that PCR assay to detect H. pylori is more sensitive than microscopy. However, we advocate for the combination of both assays to increase the strength of diagnostic accuracy due to the absence of the gold standard assay for H. pylori infection.
Highlights
Helicobacter pylori (H. pylori) is a Gram-negative bacterium that plays a remarkable role in the causation of gastrointestinal diseases such as peptic ulcers, low-grade B-cell lymphoma (MALT lymphoma), and gastric cancer [1, 2]
Several epidemiological studies evidenced that H. pyloriinfected individuals showed the incidence of gastric carcinoma [3]. e discrepancy of H. pylori prevalence has been shown among different population as well as in different countries
3 (5.77%) cases of H. pylori infection were confirmed by microscopy and 8 (15.38%) cases were confirmed by polymerase chain reaction (PCR) assay
Summary
Helicobacter pylori (H. pylori) is a Gram-negative bacterium that plays a remarkable role in the causation of gastrointestinal diseases such as peptic ulcers, low-grade B-cell lymphoma (MALT lymphoma), and gastric cancer [1, 2]. Application of molecular method such as polymerase chain reaction (PCR) has revolutionized the diagnostic approaches for the detection of H. pylori. It tracks the several genetic alteration in bacilli for understanding the drugs resistance characteristics [9] and coinfection of pathogens in gastric disease [10]. E molecular approach has helped in comparative analysis between conventional methods such as microscopy and rapid urease test with PCR in resource-limited settings for effective diagnosis and treatment. Helicobacter pylori infection is most prevalent in developing countries It is an etiological agent of peptic ulcer, gastric adenocarcinoma, and mucosal-associated lymphoid tissue (MALT) lymphoma. A total of 52 patients with gastric disorders underwent upper gastrointestinal endoscopy with biopsy. e H. pylori infection in gastric biopsies was identified after examination by microscopy and 23S rRNA specific PCR
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