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Updated: Aug 20, 2025

Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Helicobacter Pylori Infection among Patients Attending the Gastroenterology Department in Tertiary Care Hospital,
Tulasi Bhandari1, Ujjwal Laghu2, Prem Ratna2
1Department of Microbiology, St. Xavier's College, Tribhuvan University, Kathmandu, Nepal.
Insights
The rapid urease test (RUT) is more effective than direct smear or culture for detecting Helicobacter pylori infection in biopsy samples. Combining RUT with other tests offers the best diagnostic approach for H. pylori.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Diagnostic Microbiology
Background:
- Helicobacter pylori is a major human pathogen linked to gastritis, peptic ulcers, and gastric cancers.
- Accurate diagnosis of H. pylori infection is crucial for effective patient management.
- Various invasive and non-invasive diagnostic methods exist, each with varying efficacy.
Purpose of the Study:
- To determine the prevalence of H. pylori infection in patients undergoing upper GI endoscopy.
- To compare the diagnostic efficacy of invasive (Rapid Urease Test, direct smear, culture) and non-invasive (stool antigen test) methods for H. pylori detection.
- To identify factors associated with H. pylori infection.
Main Methods:
- Collected 100 stool samples and 200 gastric biopsy specimens from patients undergoing upper GI endoscopy.
- Performed Rapid Urease Test (RUT), direct smear, and culture on biopsy specimens.
- Assayed stool samples for H. pylori stool antigen (HpSA) using a kit method.
Main Results:
- H. pylori positivity rates were: RUT (26%), direct smear (11%), culture (6%), and HpSA (17%).
- Overall prevalence of H. pylori infection was 14% based on at least two positive biopsy tests.
- Infection prevalence was higher in the 46-55 age group, gastric ulcer cases, and associated with tea drinking and frequent meals (>2/day).
Conclusions:
- The Rapid Urease Test (RUT) demonstrated higher efficiency than direct smear and culture for biopsy-based H. pylori detection.
- No single test is a definitive gold standard; combining RUT with other methods is recommended for accurate H. pylori diagnosis.
- Age, gastric ulcer, tea consumption, and meal frequency are significant factors associated with H. pylori infection.
Abstract:
Helicobacter pylori is one of the most pathogenic organisms that cause gastritis, peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue (MALT) lymphoma in humans. The main aim of this study was to determine the H. pylori infection among patients undergoing upper GI endoscopy and to compare the efficacy of the diagnostic method of H. pylori infection including invasive tests (biopsy-based tests like the rapid urease test (RUT), direct smear, and culture) and the noninvasive test (HpSA). A total of 100 stool samples and 200 gastric biopsy specimens were collected (2 samples from each patient) from June to November 2019. Stool samples were processed for the detection of an H. pylori stool antigen (HpSA) by a kit method. One biopsy specimen was processed for the RUT, and another was transported to the laboratory in an Eppendorf tube containing normal saline for preparation of the smear and culture. Out of 100 participants, 26% were found to be H. pylori positive by the RUT, 11% by the direct smear, 6% by the culture, and 17% by the stool antigen test. The prevalence of H. pylori infection was found to be 14%, considering at least two of the three biopsy-based tests that gave positive results. H. pylori infection was found to be higher in the age group of 46-55 years. The overall prevalence of H. pylori infection was higher in gastric ulcer cases, followed by erosive pangastritis and gastroduodenitis. Tea drinking habits and the frequency of meal consumption more than twice a day were found to be significantly associated with H. pylori infection (P < 0.05). Hence, the RUT was found to be more efficient than the direct smear and the culture method for finding H. pylori in the biopsy sample. However, none of these methods can be considered to be the gold standard alone. Thus, the RUT combined with other tests is preferable for the detection of H. pylori.
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