Rapid Urease Test Results Research Articles

Rapid urease test according to the rules and without

The article discusses the problems of diagnosing Helicobacter pylori (H.pylori) using a rapid urease test (RUT). Features of H.pylori colonization and persistence are highlighted, which affect the results of RUT and determine the preferential use of biopsy specimens for the study, rather than gastric mucus aspirate, the localization of biopsy collection and their optimal number and the factors influencing the urease activity of H.pylori are indicated. Based on the described properties, the main causes of erroneous results and methods for preventing false negative and false positive results are given, the basic rules for working with RUT are formulated to obtain optimal results.

Evidências de Helicobacter spp. em gatos domésticos na região central do Rio Grande do Sul - pré-estudo

ABSTRACT Non-Helicobacter pylori Helicobacters(NHPH) account for causing moderate and severe gastritis in humans. Moreover, they have already been documented in the oral cavity of feline animals. The current study aims to investigate Helicobacter spp. incidence in necropsied domestic cats from central Rio Grande do Sul. Stomach, liver, and bile samples derived from 30 cats’ cadavers were subjected to rapid urease test (RUT), histopathological analysis, PCR, and nucleotide sequencing to investigate the genetic material presence and to identify the main phylogenetic group. Based on RUT results, 64.2% and 53.5% of patients were positive for gastric body and pyloric antrum, respectively. Ten out of these 15 patients were male (70%) and the positive result observed for the pyloric antrum was associated with males. Mild histopathological changes were observed in most gastric and liver samples. Gastric samples subjected to PCR presented positive results in 60.7%, whereas liver samples accounted for positive results in 17.8% and bile samples, in 3.5% of cases. There was high nucleotide identity with NHPH species. This study has found evidence that NHPH can be found in the gastric and hepatic regions, as in the bile of domestic cats, besides emphasizing the zoonotic potential of this disease

Comparative Study of Some Staining Methods for the Demonstration of Helicobacter pylori in Gastric Biopsies in Gombe State, Nigeria

Background: Currently there are different staining methods available for the demonstration of Helicobacter pylori in gastric biopsies sections. Most of these methods are technically demanding, slow and expensive with varying sensitivity and specificity. Aims: This study was to compare some of these techniques for the detection of H. pylori in routine gastric biopsy tissue sections in order to ascertain their reliability and effectiveness. Methodology: Sixty-five positive and seven negative cases of H. pylori were selected based on the results of rapid urease test, serology test and histopathological examination of the tissue sections. Histopathological examinations of sections stained by Hematoxylin and Eosin staining method (H&E), Giemsa staining method, modified Giemsa staining method, modified McMullen staining method and immunohistochemical staining were performed. Results: The sections were evaluated by two independent observers. The sensitivity and specificity for the techniques were as follow: immunohistochemistry, 100% and 100%; modified Giemsa stain, 96.9% and 85.7%; Giemsa stain, 92.3% and 81.4%; modified McMullen stain, 89.2% and 52.9%; H&E, 90.8% and 77.1%. The interobserver agreement was analyzed by Kappa (k) statistics using SPSS version 23 software. The agreement between the two observers was k: 0.859 (98.4%) for immunohistochemistry; k: 0.777 (96.9%) for modified Giemsa stain; k: 0.533 (95.2%) for Giemsa stain; k: 0.267 (92.1%) for modified McMullen stain; and k: 0.421 (93.7%) for H&E stain. Conclusion: The best results were obtained by the immunohistochemical staining and the Giemsa stainings. Although the immunohistochemistry staining method gives the best result and is very reliable, but it is fairly time consuming and expensive. Therefore, considering the cost, applicability and the reliability of the modified Giemsa or Giemsa stain, we recommend both for the detection of H. pylori in gastric biopsies sections especially in resource constrained laboratories.

Diagnostic Validity of a Serological Test with the Current Infection Marker in Thai Adults before and after Helicobacter pylori Eradication Therapy.

Helicobacter pylori infection poses significant health risks, such as gastric adenocarcinoma, necessitating accurate diagnosis and effective treatment in primary care. This study evaluated the diagnostic efficacy of the serological current infection marker (CIM) test in identifying current H. pylori infection. The CIM test samples from 159 participants undergoing gastroscopy were collected, and H. pylori-positive outpatients received triple therapy based on histology or rapid urease test results. Following treatment, 45 patients underwent a 13C-urea breath test and the CIM test for eradication assessment. For pre-eradication, the CIM test demonstrated 89.6% sensitivity, 95.7% specificity, 93.8% positive predictive value, 92.6% negative predictive value, and 93.1% accuracy. Following post-eradication, the CIM test exhibited sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 71.4%, 92.1%, 62.5%, 94.6%, and 88.9%, respectively, using the 13C-urea breath test as the reference standard. The CIM test showcased commendable diagnostic performance, emphasizing its efficacy in both pre- and post-eradication scenarios. Notably, the accuracy, non-invasiveness, user-friendliness, and cost-effectiveness of the CIM test advocate for its recommendation as a preferred diagnostic tool in primary care settings for H. pylori infection detection.

Combined Rapid Urease Test and Histology For The Diagnosis of Helicobacter Pylori Infection

Significance: Accurate detection of Helicobacter pylori (HP) is essential for the diagnosis of HP infection. The use of antibiotics and proton pump inhibitors (PPI) may result in false-negative rapid urease test (RUT) results. We aimed to determine the sensitivity and specificity of RUT compared with histology and assess the detection rate of combined RUT and histology for HP infection. Methodology: Retrospective data collection was performed on 192 patients who were tested for both RUT and histology at the time of upper endoscopy from 2017 to 2018. At least two gastric biopsies (1 from corpus, 1 from antrum) were taken each for RUT and histology. The endoscopy was performed by a single gastroenterologist and a single pathologist was responsible for interpreting the histology with hematoxylin and eosin (H&E) and Giemsa stain. The gold standard test for the diagnosis of HP infection was histology. Demographic profile, RUT and histology results were reviewed. Tests for diagnostic accuracy were computed using SPSSv23. Results: 192 patients were tested for RUT and histology. 52(27.1%) were males and 140(72.9%) were females with a mean age of 54±17 years. Epigastric pain was the most common indication (42.7%). 24(12.5%) patients tested positive for HP infection. Among these; 16(8.3%) tested positive for both RUT and histology(true-positive), while 8(4.2%) tested negative for RUT but had positive histology(false-negative). 6 out of 8(75%) patients with false negative results had PPI use. The sensitivity and specificity of RUT for the diagnosis of HP infection were 66.7 and 98.2%, respectively. While the positive and negative likelihood ratio were 37.3 and 0.34, respectively with a diagnostic odds ratio of 110. Conclusion: The HP detection rate of RUT combined with histology increased by 33% compared with RUT alone. RUT is a highly specific test for diagnosing HP infection. Given its modest sensitivity, histology plays an important role in the diagnosis of HP infection, especially in patients taking PPIs. We recommend doing histology when RUT is negative to increase the HP detection rate. Key words: retrospective, helicobacter pylori, rapid urease test, histology, RUT, giemsa stain

Efficacy and safety of high-dose esomeprazole-amoxicillin dual therapy for Helicobacter pylori rescue treatment: a multicenter, prospective, randomized, controlled trial.

Background:High-dose dual therapy (HDDT) with proton pump inhibitors (PPIs) and amoxicillin has attracted widespread attention due to its favorable efficacy in eradicating Helicobacter pylori (H. pylori). This study aimed to compare the efficacy and safety of high-dose PPI–amoxicillin dual therapy and bismuth-containing quadruple therapy for H. pylori rescue treatment.Methods:This was a prospective, randomized, multicenter, non-inferiority trial. Patients recruited from eight centers who had failed previous treatment were randomly (1:1) allocated to two eradication groups: HDDT (esomeprazole 40 mg and amoxicillin 1000 mg three times daily; the HDDT group) and bismuth-containing quadruple therapy (esomeprazole 40 mg, bismuth potassium citrate 220 mg, and furazolidone 100 mg twice daily, combined with tetracycline 500 mg three times daily; the tetracycline, furazolidone, esomeprazole, and bismuth [TFEB] group) for 14 days. The primary endpoint was the H. pylori eradication rate. The secondary endpoints were adverse effects, symptom improvement rates, and patient compliance.Results:A total of 658 patients who met the criteria were enrolled in this study. The HDDT group achieved eradication rates of 75.4% (248/329), 81.0% (248/306), and 81.3% (248/305) asdetermined by the intention-to-treat (ITT), modified intention-to-treat (MITT), and per-protocol (PP) analyses, respectively. The eradication rates were similar to those in the TFEB group: 78.1% (257/329), 84.2% (257/305), and 85.1% (257/302). The lower 95% confidence interval boundary (−9.19% in the ITT analysis, − 9.21% in the MITT analysis, and −9.73% in the PP analysis) was greater than the predefined non-inferiority margin of −10%, establishing a non-inferiority of the HDDT group vs. the TFEB group. The incidence of adverse events in the HDDT group was significantly lower than that in the TFEB group (11.1% vs. 26.8%, P < 0.001). Symptom improvement rates and patients’ compliance were similar between the two groups.Conclusions:Fourteen-day HDDT is non-inferior to bismuth-containing quadruple therapy, with fewer adverse effects and good treatment compliance, suggesting HDDT as an alternative for H. pylori rescue treatment in the local region.Trial registration:Clinicaltrials.gov, NCT04678492.

Objective Interpretation of the Rapid Urease Test for Helicobacter pylori Infection Using Colorimetry.

BackgroundThe rapid urease test (RUT) is a major diagnostic tool for detecting Helicobacter pylori infection. This study aimed to establish an objective method for measuring the color changes in the RUT kit to improve the test’s diagnostic accuracy.MethodsA UV-visible spectrophotometer was selected as the colorimeter; experiments were conducted in three stages to objectively identify the color changes in the RUT kit.ResultsFirst, the urea broth solution showed an identifiable color change from yellow to red as the pH increased by 0.2. The largest transmittance difference detected using the UV-visible spectrophotometer was observed at a 590-nm wavelength. Second, the commercialized RUT kit also showed a gradual color change according to the pH change detected using the UV-visible spectrophotometer. Third, 13 cases of negative RUT results with a biopsy specimen and 16 of positive RUT results were collected. The transmittance detected using the UV-visible spectrophotometer showed a clear division between the positive and negative RUT groups; the largest difference was observed at a 559-nm wavelength. The lowest transmittance in the negative RUT group was 64, while the highest in the positive RUT group was 56, at the 559-nm wavelength. The UV-visible spectrophotometry reading showed a consistency of 92.7% compared with that of manual reading.ConclusionA transmittance of 60 at a 559-nm wavelength detected using UV-visible spectrophotometer can be used as a cutoff value for interpreting RUT results; this will help develop an automatic RUT kit reader with a high accuracy.

Molecular detection of the virulence gene’s VacA and CagA of Helicobacter pylori by PCR

Helicobacter pylori has several virulence factors, including the ability to produce urease, which allows it to colonize the stomach and survive for long periods of time. As a results of those virulence factors of H. Pylor i causes gastritis. This study aimed to detect H. pylori using of real-time PCR amplification of VacA and CagA genes, and compare between both genes and detection by urease and creatine. For this purpose, a total of 50 patients were selected and have been clinically diagnosed with gastritis. Biopsy samples were collected from all the patients. Rapid urease test (RUT) was applied to all gastric samples to detect the presence of H. Pylori . DNA was extracted and the RT-PCR was perform to detect the VacA and CagA genes. The results of RUT showed 20 samples were positive of H. Pylori , after the Real Time-PCR test were done the results showed 27 (54%) to VacA and 25 (50%) to CagA genes were positives.

Rapid Urease Test in the Diagnosis of Pylori Infection

Introduction: Helicobacter pylori is one of the most important causes of the varied spectrum of gastroduodenal diseases. At present, several diagnostic techniques are available to identify infection with H. pylori, including rapid urease test (RUT). Objectives: The aim of this study was to evaluate RUT in the diagnosis of H. pylori infection in patients with upper GI symptoms suspecting peptic ulcer disease. Materials and Methods: It was a prospective study done in department of gastroenterology. Patients of both the sexes in the age group 18–60 years, attending with upper gastrointestinal symptoms suspecting peptic ulcer disease, during a period of 1 year were enrolled in the study. Results: Two ninety-one patients were included, 59% of male, with a mean age of 48.31 ± 15.79 years old. Most common identifiable lesions at endoscopy were antral erosion and gastritis. Significant association was observed between RUT results and biopsy findings. The study proves that positive result of RUT for H. pylori means 5.78 times chance of getting a positive finding in histology. Even though sensitivity of RUT for H. pylori infection was low, specificity was much higher. The sensitivity, specificity and positive and negative predictive values for RUT were, respectively, 41.12%, 88.3%, 71% and 68.47%, which was improved when patients taking proton-pump inhibitors were excluded. Conclusion: RUT positive alone of H. pylori infection is not sufficient as it has a low sensitivity and specificity. A negative RUT result does not fully exclude an active infection hence would need other tests like histology to confirm.

Prevalence of Helicobacter Pylori Infection in Patients with Dyspepsia in North of Iran.

BACKGROUND Dyspepsia is a common complaint among patients who refer to gastroenterology clinics. Studies have shown that there is a strong relationship between dyspepsia and Helicobacter pylori (HP) infection. We have investigated the prevalence of HP infection in patients with dyspepsia and its correlation with age and socioeconomic status (SES) of patients in Mazandaran province, northern Iran. METHODS In this cross-sectional study, patients with dyspepsia who had undergone upper gastrointestinal endoscopy were enrolled. Diagnosis of HP infection was according to the results of rapid urease test (RUT), and Giemsa staining of pathology samples. A questionnaire including endoscopic findings, demographic data, and SES information was completed for each patient. RESULTS The mean age of the 614 patients was 45.8±5 years, and 60% of them were female. Most patients had normal endoscopy (56.1%), and gastric ulcer and erosion was the most common abnormal endoscopic finding (24.7%). The prevalence of HP infection in patients with dyspepsia was about 66.6%. HP infection was associated with a lower prevalence in people aged below 30 years and good SES. CONCLUSION The prevalence of HP infection in patients with dyspepsia was 66.6%. In addition, HP infection rate was lower in people under the age of 30 years and patients with good SES.

Correlation of Helicobacter Pylori Infection with Acid Peptic Disorders.

Introduction: The acid peptic disorder is a disorder in which due to hyperacidity, there is the damageof inner lining(mucosa) of the stomach and duodenum causing various manifestations like inflammation,ulcer, etc. The acid peptic disorder is a disorder in which due to hyperacidity, there is the damage of innerlining(mucosa) of the stomach and duodenum causing various manifestations like inflammation, ulcer, etc.A major symptom of the acid peptic disorder is a pain in the abdomen typically non radiating, burning, andlocated at in epigastrium, Other include nausea, vomiting, dyspepsia, haemtemesis, and melena, etc. Uppergastrointestinal tract disorders are common in surgical practice. Helicobacter pylori is a common cause ofacid peptic disorders. Still in literature there is a controversy still exist to question about role of Helicobacterin causing acid peptic disorders. So This study was undertaken to evaluate the correlation of H. Pyloriinfection with acid peptic disorders. Method: This study was a prospective observational. The durationof this study was from September 2017 to September 2019. The numbers of patients were 150. After theestablishment of a clinical diagnosis of an acid peptic disorder, the patient was posted for endoscopy. H.pylori status was determined by the rapid urease test. The data collected included the presenting complaints,clinical signs, endoscopic findings, results of rapid urease test, and histopathological examination. Thepresence of H pylori infection was correlated with symptoms, and endoscopy findings. Results: In the presentstudy, 150 patients with upper gastrointestinal symptoms were studied It was found that the maximumnumber of subjects belonged to the age group 31-40 yrs. It was found that of subjects male 112 and female.It was found that maximum number of subjects had pain in epigastric region 120 cases i. e. 80% followedby symptoms nausea 75 cases ie. 50%. about endoscopic findings 70 patients were having gastritis, 15 hada duodenal ulcer,9 patients had Duodenitis, the gastric ulcer was found in 08 patients, gastric malignancyin 02 patients and 46 patients had endoscopic normal mucosa. The highest positivity of RUT was seen inpatients of duodenal ulcers (86.66%), followed by gastritis (82.85%) and gastric ulcer (75%). Conclusions:Present study, we have found that there is an association of H. Pylori infection in an acid peptic disorder likeduodenal ulcer, gastric ulcer, and gastritis.

Isolation of Helicobacter pylori using leftover tissue in the rapid urease test kit

Isolation of Helicobacter pylori is considered difficult because of the requirement of the additional biopsy tissue and the effort involved in the isolation of the bacterium. We investigated whether Hpylori can be cultured from tissue samples used for the rapid urease test (RUT). Totally, 174 specimens from 87 patients referred for endoscopy were prospectively included. During endoscopy, two biopsy specimens were obtained, one each from the gastric antrum and the corpus, and were placed into a commercially available RUT kit. After detection of urease activity, Hpylori was cultured using tissue leftover in the RUT, regardless of the result. Hpylori was successfully isolated using leftover tissue in 72.4% (63/87) of the patients. In 32 patients, Hpylori was isolated from both specimens, while in 31 patients, it was isolated from either antrum or corpus. Eighty-one Hpylori strains were isolated from 141 specimens with positive RUT results (57.4%), whereas 14 strains were isolated from 33 specimens with negative RUT results (42.4%). The median interval between tissue acquisition and inoculation onto the isolation media was 3.6hours (range: 0.5-27.5hours) in cases with successful cultures, compared to 23.5hours (range: 0.5-76.0hours) in cases with failed cultures. Among the positive RUT tissues, 80.4% (45/56) were cultured successfully when the tissue was inoculated within 4hours of the biopsy. RUT kits can be used as transport media for Hpylori, and this media is most efficient when used within 4hours of the test.

Stool Antigen Testing, a Reliable Noninvasive Method of Assessment of Helicobacter pylori Infection Among Patients with Gastro-duodenal Disorders in Cameroon.

Several techniques such as invasive and noninvasive are used for the diagnosis of H. pylori infection. The aim of this study was to compare the results of rapid urease test, stool antigen test and serology in diagnosing H. pylori infection in Cameroon. Hundred patients (66 women and 34 men) were enrolled. Each patient gave a written consent. The study was approved by the local Ethical Committee of Medical Sciences and the institutional review board. From each patient, blood, stool and gastric biopsies samples were collected for H. pylori detection using three methods: stool antigen test, serology and rapid urease test (RUT), taken as gold standard. Statistical analysis was performed using Graph pad Prism 7. Helicobacter pylori infection was detected in 43%, 45% and 73% of patients based on the RUT, stool antigen test and serology, respectively. The difference was statistically significant between serology and RUT (P = 0.0026), but not between stool antigens test and RUT (P = 0.288). Taken RUT as gold standard, the sensitivity, specificity, positive and negative predictive values of stool antigens test and serology were 65.11, 70.17, 62.22 and 72.72%; 88.37, 40.35, 55.77 and 82.14%, respectively. The accuracy of stool antigen test and serology was 68 and 61%, respectively. Our finding showed that stool antigen test can be used as a noninvasive method of assessment of H. pylori infection in our setting. Serological test can be used in screening; however, further diagnostic tests need to be carried out to confirm seropositive cases.

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

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.

Factors for improving the diagnostic efficiency of the rapid urease test from the gastric corpus

Objective: This study aimed to evaluate the optimal biopsy site for Helicobacter pylori detection by comparing the results of rapid urease test (RUT) between the gastric corpus and the antrum.Methods: A biopsy specimen from each subject was obtained from the corpus and from the antrum. For each subject, the two specimens were separately immersed in two different RUT kits. Positive reaction times were measured at 20 minutes and 1, 3, and 24 hours. If either of the two RUT kits showed a positive reaction, H. pylori infection was confirmed.Results: A total of 310 H. pylori-infected subjects were eligible for study inclusion. Compared with the antrum, positive RUT reaction times in the corpus were shorter when the degree of gastric atrophy was moderate or severe (p = .001 and p < .001, respectively). A multivariate analysis revealed that the factors resulting in a faster positive RUT reaction in the corpus were age ≥50 years (odds ratio [OR] = 1.84; 95% confidence interval [CI] = 1.10–3.08; p = .021) and severe gastric atrophy (OR = 2.41; 95% CI = 1.13–5.13; p = .023). Also, severe gastric atrophy was an independent factor associated with positive RUT reaction only in the corpus (OR = 5.12; 95% CI = 1.55–16.88; p = .007).Conclusions: In subjects aged ≥50 years or with severe gastric atrophy, biopsy of the corpus mucosa optimized the efficiency of H. pylori detection through a faster positive RUT reaction.

Role of Helicobacter Pylori stool antigen test in the diagnosis of Helicobacter Pylori infection

Introduction: Helicobacter pylori (H. pylori) infection is common in developing countries. There are various invasive and non-invasive methods for diagnosing H. pylori infection. Stool antigen test is a new non-invasive method to diagnose H. pylori infection. In this study we evaluated the diagnostic accuracy of HpSA for H. pylori infection in patients with gastrointestinal (GI) complaints. Methods: Sixty patients including 28 men and 32 women with mean age of 49.2 ± 19.8 years undergoing diagnostic endoscopy with 30 positive and 30 negative rapid urease test (RUT) and histology results for H. pylori infection were evaluated. H. pylori stool antigen test (HpSA) was measured in these patients and sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for HpSA were calculated. Results: Among 31 positive HpSA results, 2 were negative in RUT and histology and among 29 negative HpSA results, 1 was positive in RUT and histology results. Sensitivity, specificity, PPV, NPV and accuracy for HpSA in diagnosing H. pylori infection were 96.67%, 93.33%, 93.55%, 96.55% and 95%, respectively. Conclusion: Although the sensitivity and specificity of the HpSA are evaluated in a relatively small sample size, these results showed that HpSA is a useful test in diagnosing H. pylori infection in patients with upper GI complaints.

Detection of Clarithromycin-Resistant Helicobacter pylori by Polymerase Chain Reaction Using Residual Samples from Rapid Urease Test

Background: Approximately 50% of the world population is infected with Helicobacter pylori, which corresponds to a high infection rate. Furthermore, the incidence of antibiotic-resistant H. pylori has increased with the recent rise in use of antibiotics for H. pylori elimination, suggesting growing treatment failures. Aim: The study was aimed to assess the use of residual samples from rapid urease test (RUT) for biomolecular testing as an effective and accurate method to detect antibiotic-resistant H. pylori. Settings and Design: This study was a retrospective study performed using data obtained from medical records of previously isolated H. pylori strains. Materials and Methods: RUT was conducted for 5440 biopsy samples from individuals who underwent health examination in South Korea. Subsequently, 469 RUT residual samples were randomly selected and subjected to polymerase chain reaction (PCR) to detect antibiotic-resistant H. pylori. Statistical Analysis Used: The Chi-square test was used to analyse categorical data. P < 0.05 was considered statistically significant. Results: The results showed a concordance between the results of PCR and conventional RUT in 450 of 469 samples, suggesting that the H. pylori PCR test is a time- and cost-effective detection method. Conclusions: This study demonstrated that PCR test can aid physicians to prescribe the appropriate antibiotics at the time of diagnosis, thus preventing the reduction in H. pylori eradication due to antibiotic resistance, averting progression to serious diseases and increasing the treatment success rate.

A Multiplex-Urease PCR Assay for Detection of Helicobacter pylori Infection Directly from Gastric Biopsy Specimens and Comparison of Multiplex- Urease PCR Results with Rapid Urease Test and Histopathology

Purpose: To develop a multiplex-urease PCR assay specific for ureA and ureB genes directly from gastric biopsy specimens and compare the results of multiplex-urease PCR assay with rapid urease test (RUT) and histopathology. Methodology: This study was conducted on 109 patients. A RUT was run; histopathological staining and multiplex urease PCR were applied to biopsy specimen to detect H. pylori. Multiplex-urease PCR, RUT and histopathology results were compared by calculating Cohen’s kappa coefficient. Results: A multiplex-urease PCR assay specific for ureA and ureB genes was developed to detect H. pylori directly from biopsy specimens. Cohen's kappa coefficient results of histopathological staining and multiplex-urease PCR indicate a substantial agreement. There was a moderate agreement between the results of histopathological staining and RUT results. There is a fair agreement between the multiplex urease PCR and the RUT results. Furthermore, the multiplex-urease PCR can detect H. pylori in some samples that are identified as negative by the rapid urease test and histopathological staining method. Moreover, in some patient samples ureA could not be detected while ureB detected. Conclusion: Multiplex-urease PCR assay was developed to detect ureA and ureB genes of H. pylori directly from gastric biopsy specimens. Comparison results indicated that detection rate of H. pylori with multiplex-urease PCR and histopathological staining is higher than the RUT. Moreover, it is critical to apply RUT test to biopsy specimens taken from both antrum and corpus part as in multiplex urease PCR assay. Furthermore, developing a multiplex PCR for both ureA and ureB is essential to detect active H. pylori infection.

Role of Proton Pump Inhibitors on Rapid Urease Test (PYLO DRY) and Histopathological Examination

In the diagnosis of Helicobacter pylori infection, rapid urease test (RUT) plays an important role. According to previous studies, if there was a low density of Helicobacter pylori in the stomach, then rapid urease test requires longer time to become positive. Density of Helicobacter pylori could be reduced by recent use of PPIs, hence rapid urease test may require longer reading time as well. The main objective was to determine the effect of PPI on the results of rapid urease test (PYLO DRY) and histopathology. Two antral biopsies were obtained from 35 dyspeptic patients, who underwent gastro intestinal endoscopy from March 2015 to July 2015. An informed consent from all patients and approval from the institutional ethical committee were obtained before proceeding. Antral biopsies were subjected for rapid urease test (PYLO DRY from HALIFAX RESEARCH LABORATORY KOLKATA, INDIA) and histopathologic examinations. The results of Rapid urease test were observed after 1 hour and 24 hours. The histopathologic examinations were used as the gold standard. PYLO DRY was positive in 17.6% (6) and 53 % (18) when observed after one hour and 24 hours respectively. Eight were positive during histopathological examination. In our study, 24 hours Rapid urease test yeilded higher sensitivity but lower specificity compared to RUT at 1 hour for diagnosis of H.pylori infection in patients who were on PPI.

The relationship between recurrent aphthous stomatitis, and periodontal disease and Helicobacter Pylori infection.

Recurrent aphthous stomatitis (RAS) is a common oral mucosal disease with unknown etiology. This cross-sectional study aimed to test the hypothesis that Helicobacter pylori and periodontal disease might play an etiological role in RAS. Dental plaque samples obtained from 38 patients with RAS and 43 healthy individuals via periodontal examinations were examined for H. pylori colonization. H. pylori was identified using the rapid urease test (RUT). The periodontal status of the patients and controls was based on the following periodontal parameters: periodontal pocket depth (PPD), the plaque index (PI), the gingival index (GI), and clinical attachment loss (CAL). RUT results were positive in 34 (89.5%) of the 38 patients and 24 (55.8%) of the 43 controls (P = 0.002). There were not any significant differences in mean PPD, PI, GI, or CAL between the patient and control groups (P > 0.05). Mean PPD, PI, GI, and CAL were higher in the RUT-positive RAS patients than in the RUT-negative patients (P > 0.05, for all). The present findings show that H. pylori might have played an etiological role in RAS and might have caused periodontal disease, but RAS was not associated with any of the periodontal parameters examined in this study. The present study indicates that H. pylori plays a role in the development of RAS, but periodontal diseases have no effect on it. Eradicating H. pylori might be useful to prevent RAS.