Effect of specimen collection techniques,transport media,and incubation of cultures on the detection rate ofHelicobacter pylori

Culture and histologic examination are considered gold standard methods for the detection ofHelicobacter pylori, but discrepancies may occur with either method. Failure to detectHelicobacter pylori may be due to sampling error, inappropriate transport or culture media, or insufficient duration of the incubation period. Rates of detection ofHelicobacter pylori by culture and histopathologic examination of gastric mucosal biopsy specimens were determined in 102 consecutive dyspeptic patients. In a separate group of 60 patients, rates of detection ofHelicobacter pylori by culture of antral brushings and the length of incubation required in selective and nonselective culture media were studied. In the first group of 102 patients, the combination of culture and histologic examination detected 54Helicobacter pylori-positive patients, whereas the separate techniques each detected 51Helicobacter pylori-positive patients. In the second group of 60 patients evaluated by culture of antral brushings, the rate of detection ofHelicobacter pylori was 25 of 60 and was similar for culture (25/60) and histologic examination (25/60). In the second group the length of incubation required to detectHelicobacter pylori was different for selective and nonselective media. In nonselective media, incubation of up to ten days was required to detect allHelicobacter pylori infections, whereas in selective media seven days was sufficient. Rates of detection ofHelicobacter pylori by culture, histopathologic examination and culture from brushings were similar, whereas the combination of culture and histopathologic examination achieved a superior rate of detection. The incubation period required for the detection ofHelicobacter pylori by culture was a minimum of seven days and was dependent on the culture medium used.