Evaluation of the motility indole urease (MIU) test to detect Helicobacter pylori infection.

The aim of this study was to evaluate the diagnostic value of the new motility indole urease (MIU) test and Campylobacter Like Organism (CLO) test with culture as the gold standard. This study were done on 225 biopsy samples from gastric antra taken from chronic dyspeptic patients from several hospitals in Jakarta. On the MIU test, the biopsy tissue sample was submerged in the MIU tube agar to a depth of about 2/3 from the surface, and incubated at room temperature. Another piece of biopsy tissue was used for CLO and cultured. The CLO and MIU tests were considered positive if the color changed from yellow to red, and were considered negative if there was no color change within 24 hours. The CLO test compared with culture had 75.9% sensitivity, 78.6% specificity, 76.6% positive predictive value and 78% negative predictive value, whereas the result of the MIU test compared with the culture method showed 96.3% sensitivity, 82.1% specificity, 83.2% positive predictive value, and 96% negative predictive value. The MIU test with its higher sensitivity and specificity may be used as an alternative diagnostic method for H. pylori infection.

Patterns of Helicobacter pylori isolate resistance to fluoroquinolones, amoxicillin, clarithromycin and metronidazoles.

Helicobacter pylori eradication using the three antibiotic regimen of amoxicillin, clarithromycin and metronidazole often fails, making it imperative to find substitutes. The following study made use of 72 H. pylori isolates derived from pyloric antrum mucosa biopsies of gastritis and chronic dyspepsia patients treated at the Cipto Mangunkusumo National General Hospital and three private hospitals in Jakarta. Testing for H. pylori sensitivity to various antimicrobials was conducted using the disk diffusion method (Kirby Bauer) and procedures determined by the Clinical and Laboratory Standards Intitute (CLSI)/NCCLS. The resistance rates of the isolates were 100% for metronodazole, 27.8% for clarithromycin, 19.4% for amoxicillin, 6.9% for ciprofloxacin, norfloxacin and ofloxacin, 2.8% for sparfloxacin and gatifloxacin, and 1.4% for levofloxacin and moxifloxacin. Fluoroquinolons have the lowest resistance compared to amoxicillin, clarithromycin and metronidazole.