Evaluation of methods for identification of Campylobacter pyloris infection

Fifty unselected patients undergoing routine esophagogastroduodenoscopy were evaluated for infection with Campylobacter pyloris (CP). Antral specimens were cultured, and biopsies from the antrum and the body of the stomach were examined histologically. Specimens of antral brushings were analyzed with Gram stain, and urease testing was performed on gastric aspirates, antral brushings, and antral biopsy homogenates. Twenty-seven (54%) patients were CP-positive by silver stain and/or culture of mucosal biopsies. The simplest and fastest diagnostic methods was Gram stain of antral brushing, which was 93% sensitive and 100% specific. CP-negative patients were more likely to have normal histology in antrum and body tissues, while CP-positive patients usually exhibited superficial or chronic gastritis (p less than 0.01). Using ELISA technique, 67% of all patients and 89% of CP-positive patients had serum antibodies against sonicated CP organisms. We conclude that evidence of gastric CP infection is common, is associated with inflammatory changes of the gastric mucosa, is suggested by finding antibodies to CP in serum, and can be accurately and rapidly diagnosed by staining of endoscopically derived cytology and biopsy specimens.