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. 2015 Jan;3(1):11.
doi: 10.3978/j.issn.2305-5839.2014.11.16.

Evaluation of methods for H. pylori detection in PPI consumption using culture, rapid urease test and smear examination

Farideh Siavoshi  1 , Parastoo Saniee  1 , Saman Khalili-Samani  1 , Farideh Hosseini  1 , Fahimeh Malakutikhah  1 , Marzieh Mamivand  1 , Somayeh Shahreza  1 , Amir Houshang Sharifi  1
Affiliations

Evaluation of methods for H. pylori detection in PPI consumption using culture, rapid urease test and smear examination

Farideh Siavoshi et al. Ann Transl Med. 2015 Jan.

Abstract

Background: Culture, rapid urease test (RUT) and smear examination have been used as reliable methods for diagnosis of H. pylori infection. Accurate performance of these tests requires good quality biopsies with considerable number of bacterial cells. However, consumption of proton pump inhibitors (PPIs) affects growth and urease activity of H. pylori, leading to false negative results. In this study the efficacy of culture, RUT and smear examination was assessed and the effect of PPI consumption was evaluated.

Methods: Two antral biopsies from 530 dyspeptic patients with and without PPI consumption were used for RUT, culture and smear examination. Statistical analysis was used to determine the association between results of culture, RUT or smear examination and PPI consumption. Sensitivity and specificity of three tests were calculated by standard methods.

Results: H. pylori infection was detected in 40% of patients by culture, 48.3% by RUT and 21.1% by smear examination and the overall detection rate was 54%. A strong correlation was found between PPI consumption and negative results of culture and RUT (P<0.05) but not smear examination. The sensitivity of RUT was reduced as a result of PPI consumption. This reduction was more profound in 1-hr RUT (92.2% to 74.4%) compared with 24-hr RUT (93.9% to 81.6%).

Conclusions: Prevalence of H. pylori was declined, compared with previous studies. This decrement could be due to false negative results of H. pylori diagnostic tests, among which culture and RUT are mostly affected by PPI. Accordingly, PPI consumption should be stopped before performance of endoscopy.

Keywords: H. pylori; culture; diagnosis; rapid urease test (RUT); smear.

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Figures

Figure 1
Figure 1
Photomicrograph of Gram-stained smears of antral biopsies, showing (A) typical spiral cells of H. pylori appearing with even or (B) patchy distribution (magnification ×1,250).
See this image and copyright information in PMC

References

    1. Versalovic J.Helicobacter pylori. Pathology and diagnostic strategies. Am J Clin Pathol 2003;119:403-12. - PubMed
    1. Suerbaum S, Michetti P.Helicobacter pylori infection. N Engl J Med 2002;347:1175-86. - PubMed
    1. Li Z, Zou D, Ma X, et al. Epidemiology of peptic ulcer disease: endoscopic results of the systematic investigation of gastrointestinal disease in China. Am J Gastroenterol 2010;105:2570-7. - PubMed
    1. Parkin DM. The global health burden of infection-associated cancers in the year 2002. Int J Cancer 2006;118:3030-44. - PubMed
    1. Nouraie M, Latifi-Navid S, Rezvan H, et al. Childhood hygienic practice and family education status determine the prevalence of Helicobacter pylori infection in Iran. Helicobacter 2009;14:40-6. - PubMed