Helicobacter pylori culture: from bench to bedside

Helicobacter pylori (H. pylori) infection is a widespread infection that causes various gastroduodenal diseases and some extraintestinal disorders. Curing this infection remains challenging for clinicians, mainly because of bacterial resistance towards the few available antibiotics. Therefore, as for other infectious diseases, therapeutic approaches should be opportunely designed using the principles of antimicrobial stewardship. Theoretically, only susceptibility-based antimicrobial therapy should be considered as appropriate for treating this infection. Unfortunately, H. pylori owns some particular characteristics that make the infection slightly peculiar. More specifically, it is "fastidious" about growing in culture, and its isolation is not easily achieved, even in dedicated laboratories that, to make matters worse, are only scantily spread among countries. We examined the pros and cons of bacterial culture for antibiotic susceptibility testing before different therapy lines, and its applicability in the real clinical life.