Rapid diagnosis of Campylobacter pylori by Gram's stain

Campylobacter pylori (CP) is implicated as a probable pathogen in gastritis and peptic ulcer disease. A blinded prospective study of 112 subjects evaluated how Gram's-stained touch preparations of mucosal biopsies compared with culture, routinely processed hematoxylin and eosin (H and E) and Warthin-Starry (WS) staining in confirming the presence of CP. At endoscopic examination, two mucosal biopsies were taken from the gastric antrum and two from the fundus of each subject. One biopsy from each site was Gram's stained and cultured and the other submitted for H and E and WS. Fifty of the 112 subjects had positive results for CP by at least two of the tests (44.6%). Histologically, 48 (96%) of the CP-positive subjects showed the presence of gastritis. Of 55 subjects who had gastritis, 50 had CP (91%). If both sites in the stomach were taken into account, the sensitivity and specificity of Gram's staining in detecting CP were 92% and 100%, respectively. These results are comparable to H and E and WS and slightly better than culture. The diagnosis of CP can be made accurately, rapidly, and inexpensively by Gram's stained touch preparations of mucosal biopsies.