Evaluation of different methods for detection of Helicobacter pylori in patients with gastric disease

Endoscopic gastric antral biopsy specimens (133) from 92 dyspeptic patients with endoscopically evident gastritis (34; including one patient with dual pathology) gastric ulcer (13), duodenitis (17; including one patient with dual pathology) duodenal ulcer (29) and 41 subjects of non ulcer dyspepsia (NUD) with endoscopically normal upper gastrointestinal tract were examined for H. pylori by stained smear, various urease tests, culture and histopathology. Crushed tissue smear stained by Gram's method using carbol fuchsin counterstain proved to be the simplest and a reliable technique. Up to 4 h urease broth + ve test correlated well with smear and culture. Positive association of H. pylori with disease was considered when at least two of the above methods were suggestive. Significantly higher positivities were observed in gastritis (61.7%), gastric ulcer (84.6%), duodenitis (58.8%) and duodenal ulcer (82.8%) patients, as compared to NUD subjects (46.3%). Severe histopathological lesions were frequently associated with multiple bacteriological test positives.