Analysis of four different methods for the detection of helicobacter pylori infection in patients with dyspepsia

Helicobacter pylori [H.pylori] is a major causative agent of chronic gastritis and peptic ulcer disease. Furthermore, H.pylori plays an important role in the pathogenesis of gastric cancer and gastric mucosa-associated lymphoid tissue [MALT] lymphoma. So the accurate diagnosis of the H.pylori infection is of clinical importance to compare the accuracy of four tests, including culture, histopathology, rapid urease test and serology for the diagnosis of H.pylori infection in patients with dyspepsia. National Hepatology and Tropical Medicine Research Institute. Prospective study. Sixty patients complaining of dyspepsia and undergoing upper endoscopy were included in the study, three antrum biopsy specimens were taken from each patient for rapid urease test, histopathological examination and culture. Blood samples were taken after endoscopic examination and sera were separated by centrifugation and stored at -70C until analyzed. A total of 60 patients were included in this study, 24 males and 36 females. Their age ranged from 23-65 years, histopathology was positive in 45 patients [75%]. Rapid urease test was positive in 36 patients [60%]. Culture was positive in 24 patients [40%] and Serology was positive in 45 patients [75%]. We found that If endoscopy was to be performed, a biopsy urease test was recommended as the test of first choice, with histology recommended only in negative cases. Culture is recommended in treatment-resistant cases to allow testing for antibiotic susceptibility. If endoscopy is not to be performed, serology is also an accurate test, but coupling it with testing of virulence strains is preferred to avoid unnecessary treatment