Evaluation of the one-minute ultra-rapid urease test for diagnosing Helicobacter pylori

Abstract

SummaryTo determine the diagnostic accuracy of the one-minute ultra-rapid urease test for diagnosing Helicobacter pylori infection, two biopsies were taken from both the gastric corpus and antrum from 1000 patients undergoing upper gastrointestinal endoscopy. All the biopsies were subjected to the one-minute ultra-rapid urease test before imprint smears were prepared from them. Thereafter, the biopsies were fixed in 10% formalin and histological sections were examined for the presence of H pylori by a pathologist who was not aware of the clinical details or the results of the urease test. The prevalence of H pylori in the gastric antrum and corpus was 86.7% and 53.3%, respectively. The sensitivity, specificity, positive and negative predictive value and the overall diagnostic accuracy of the ultra-rapid urease test to diagnose H pylori infection in the gastric antrum were 92%, 100%, 100%, 66%, and 93%, respectively. The corresponding figures for the gastric corpus were 83%, 100%, 100%, 85%, and 91%, respectively. It is concluded that the one-minute ultra-rapid urease test has a high sensitivity and specificity and may be used as a rapid and cheap method to diagnose H pylori infection. Keywords: diagnosis; Helicobacter pylori; urease testingThere are several methods of diagnosing Helicobacter pylori infection. 1 The fact that the bacterium produces urease that splits urea has been exploited to develop several rapid urease tests. Although several of these are available commercially, 2 they are relatively expensive and may therefore not be available to all clinicians, especially in developing countries. However, there are several locally made urease tests that are very easy to prepare and are inexpensive. [3][4][5] There are, however, doubts about the sensitivity and specificity of these tests. We have been using the one-minute ultra-rapid urease test (URUT) 3 for most of our studies. This study was undertaken to assess the reliability of the URUT compared to histology.We first carried out a pilot study on 20 gastric biopsies to see whether the same gastric biopsy could be used for URUT, imprint smears and histology. The results of this pilot study showed that the same biopsy tissue could be used to perform the URUT and prepare imprint smears without adversely aVecting the tissue for subsequent histological examination. Patients and methodsOne thousand patients undergoing upper gastrointestinal endoscopy were studied. Patients who were receiving proton pump inhibitors, antibiotics or bismuth-containing agents and patients who had received therapy aimed at eradication of H pylori were excluded from the study. Four gastric mucosal biopsies were taken: two from the antrum within 4 cm of the pylorus (one from the greater and the other from the lesser curvature) and two from the corpus of the stomach.The one-minute ultra-rapid urease test was freshly prepared as described by Thillainayagam et al. 3 Briefly, each biopsy tissue was placed immediately into a capped Eppendorf tube containing 0.5 ml of a freshly prepared s...

Gastroscopic Real-Time13C-Urea Breath Test

“…The H. pylori prevalence found in this study is comparable with that reported in earlier investigations [1,6,25]. The H. pylori re− sults were positive in approximately 25 % of the patients in both groups (20.4 % with HUT and 30.2 % with GBT; n. s.), correspond− ing to known prevalence rates of H. pylori for populations in Switzerland (24 %) [26,27] and western Europe (7 ± 54 %) [5] in patients of comparable age and socio−economic status [5,26,27].…”

Helicobacter pylori infection progresses proximally associated with pyloric metaplasia in age-dependent tendency: a cross-sectional study

“…In the present study, biopsies from five predetermined sites in stomach were taken from each patient to approach the correlation among H. pylori distribution, mucosa inflammation, gland type and age in different areas of stomach. Misra et al have shown the utility of using the same biopsy specimen for two tests [ 26 ].…”

Are Dental Plaque, Poor Oral Hygiene, and Periodontal Disease Associated With Helicobacter pylori Infection?

“…Upper gastro‐intestinal endoscopy was carried out, findings were recorded, and biopsy specimens taken from the antrum were fixed in 10% formalin for histologic examination and detection of H. pylori by half‐Gram stain. The rapid urease test was carried out in the antral biopsy as per the method mentioned in earlier studies using the test 15 …”

“…The rapid urease test was carried out in the antral biopsy as per the method mentioned in earlier studies using the test. 15 Serological examination for determination of H. pylori infection included determination of immunoglobulin G (IgG) antibody levels for H. pylori. ‡ A value ‡40 IU/ml was taken as positive and <40 IU/ml was taken as negative.…”