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Dahlén G, Hassan H, Blomqvist S, Carlén A. Rapid urease test (RUT) for evaluation of urease activity in oral bacteria in vitro and in supragingival dental plaque ex vivo. BMC Oral Health 2018; 18:89. [PMID: 29776416 PMCID: PMC5960132 DOI: 10.1186/s12903-018-0541-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 04/26/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Urease is an enzyme produced by plaque bacteria hydrolysing urea from saliva and gingival exudate into ammonia in order to regulate the pH in the dental biofilm. The aim of this study was to assess the urease activity among oral bacterial species by using the rapid urease test (RUT) in a micro-plate format and to examine whether this test could be used for measuring the urease activity in site-specific supragingival dental plaque samples ex vivo. METHODS The RUT test is based on 2% urea in peptone broth solution and with phenol red at pH 6.0. Oral bacterial species were tested for their urease activity using 100 μl of RUT test solution in the well of a micro-plate to which a 1 μl amount of cells collected after growth on blood agar plates or in broth, were added. The color change was determined after 15, 30 min, and 1 and 2 h. The reaction was graded in a 4-graded scale (none, weak, medium, strong). Ex vivo evaluation of dental plaque urease activity was tested in supragingival 1 μl plaque samples collected from 4 interproximal sites of front teeth and molars in 18 adult volunteers. The color reaction was read after 1 h in room temperature and scored as in the in vitro test. RESULTS The strongest activity was registered for Staphylococcus epidermidis, Helicobacter pylori, Campylobacter ureolyticus and some strains of Haemophilus parainfluenzae, while known ureolytic species such as Streptococcus salivarius and Actinomyces naeslundii showed a weaker, variable and strain-dependent activity. Temperature had minor influence on the RUT reaction. The interproximal supragingival dental plaque between the lower central incisors (site 31/41) showed significantly higher scores compared to between the upper central incisors (site 11/21), between the upper left first molar and second premolar (site 26/25) and between the lower right second premolar and molar (site 45/46). CONCLUSION The rapid urease test (RUT) in a micro-plate format can be used as a simple and rapid method to test urease activity in bacterial strains in vitro and as a chair-side method for testing urease activity in site-specific supragingival plaque samples ex vivo.
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Affiliation(s)
- Gunnar Dahlén
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Box 450, SE 40530 Gothenburg, Sweden
| | - Haidar Hassan
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Box 450, SE 40530 Gothenburg, Sweden
| | - Susanne Blomqvist
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Box 450, SE 40530 Gothenburg, Sweden
| | - Anette Carlén
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Box 450, SE 40530 Gothenburg, Sweden
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SHIRAI T, HARASAWA S, MIWA T. The Detection of Campylobacter pylori (Cp) in Gastro‐Duodenal Disease: The Efficacy of the Rapid Urease (RU) Test and Relationship between Endoscopic Findings, Histological Gastritis and Presence of Cp. Dig Endosc 2007. [DOI: 10.1111/j.1443-1661.1990.tb00353.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
| | | | - Takeshi MIWA
- Internal Medicine 6, Tokai University, Kanagawa, Japan
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Affiliation(s)
- T U Westblom
- Department of Internal Medicine, College of Medicine, Texas A&M University, Central Texas Veterans Health Care System, Temple, USA
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Lee N, Lee TT, Fang KM. Assessment of four rapid urease test systems for detection of Helicobacter pylori in gastric biopsy specimens. Diagn Microbiol Infect Dis 1994; 18:69-74. [PMID: 8062534 DOI: 10.1016/0732-8893(94)90067-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
An in vitro experiment and an in vivo clinical trial were both performed in order to assess the efficacy of four biopsy urease test systems, including one commercial kit, Temmler CUT test (Temmler Pharma, Marburg, Germany), for the rapid detection of Helicobacter pylori. We first evaluated four rapid urease test systems by inoculating bacterial suspensions of different concentrations into urea-containing media and observing the color change at room temperature. We found that the CUT test was superior in vitro to the other three urease test systems. As was expected, the lower the concentration of the inoculum, the slower was the color change and the fewer were the positive results noted. The minimal concentration of H. pylori for a positive urease test at 24 h was 1000-10,000 colony-forming units/ml in 1 drop of bacterial suspension inoculated. We then evaluated four biopsy urease test systems for the rapid diagnosis of H. pylori infection in antral and fundal mucosa biopsy specimens of 37 patients undergoing upper gastrointestinal endoscopy. All four test systems were 100% specific when compared with culture. In 69 culture-positive biopsy specimens, the CUT test was not only more sensitive (72%) than the other three systems (42%, 51%, and 45%, respectively), but also gave the fastest reaction by detecting more culture-positive biopsy specimens after 3 h of incubation at room temperature. The differences were statistically significant.
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Affiliation(s)
- N Lee
- Department of Pathology and Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan, Republic of China
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5
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Vogt K, Hahn H. Influence of omeprazole on urease activity of Helicobacter pylori in vitro. ZENTRALBLATT FUR BAKTERIOLOGIE : INTERNATIONAL JOURNAL OF MEDICAL MICROBIOLOGY 1993; 280:273-8. [PMID: 8280951 DOI: 10.1016/s0934-8840(11)80965-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The influence of omeprazole on urease activity of 13 Helicobacter pylori strains was assessed in vitro employing different inocula of the bacteria and various concentrations of omeprazole. Bacteria were grown in liquid culture supplemented with omeprazole for 48 h. Afterwards, bacterial numbers were assessed and urease activity was measured in a spectrophotometric assay. In 10 strains, omeprazole had no influence on urease activity at concentrations up to 8 mg/l; higher concentrations had a bacteriostatic effect. Three strains were more resistant to omeprazole: These showed a marked diminution of urease activity although bacterial numbers were only slightly reduced. Thus a possible inhibitory effect of omeprazole should be taken into account when urease of Helicobacter pylori is measured for diagnostic purposes.
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Affiliation(s)
- K Vogt
- Institut für Medizinische Mikrobiologie und Infektionsimmunologie, Freien Universität, Berlin, Germany
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6
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Ito M, Enomoto H, Usa T, Villadolid MC, Ohtsuru A, Namba H, Sekine I, Yamashita S. Expression of parathyroid hormone related peptide in human pituitary tumours. J Clin Pathol 1993; 46:682-3. [PMID: 8157764 PMCID: PMC501406 DOI: 10.1136/jcp.46.7.682] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The presence of parathyroid hormone related peptide (PTHrP) was studied in 20 patients with pituitary adenomas and one patient with pituitary adenocarcinoma. PTHrP expression was shown in almost all of the pituitary adenomas (95%) and in 100% (n = 7) growth hormone producing pituitary adenomas. A metastatic lesion from a pituitary growth hormone producing adenocarcinoma revealed strongly expressed PTHrP. It was weakly detected in normal pituitary cells in all of the specimens (n = 10). There was no significant correlation, however, between PTHrP expression and the clinical or pathological features of growth hormone producing tumours. Apart from an important role in the physiological function of the pituitary gland, PTHrP may be closely related to somatotroph tumorigenicity.
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Affiliation(s)
- M Ito
- Department of Pathology, Nagasaki University School of Medicine, Japan
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7
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Zaitoun AM. Histology compared with chemical testing for urease for rapid detection of Helicobacter pylori in gastric biopsy specimens. J Clin Pathol 1993; 46:684-5. [PMID: 8157765 PMCID: PMC501407 DOI: 10.1136/jcp.46.7.684] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Gastric biopsy specimens from 283 patients with ulcer and non-ulcer dyspepsia attending five gastroenterology clinics in the northern region of the United Arab Emirates (UAE) were tested by the agar gel test (n = 115) or the ultra-rapid endoscopy room test (n = 168) for the presence of Helicobacter pylori urease. Results were compared with a histological technique using the Romanowsky type (Diff-3) stain for detecting H pylori in both antral and body type gastric mucosa. A sensitivity of 94% and specificity of 100% using the agar gel test compared with 87% sensitivity and 99.3% specificity for the ultra-rapid endoscopy room test. Grading of H pylori in gastric biopsy specimens showed that the higher the histological grade, the more likely that the urease test would be positive. Both forms of urease tests have high specificity for detecting H pylori in gastric biopsy specimens, although the urea agar test has a higher sensitivity than the ultra-rapid test. Low numbers of H pylori in gastric biopsy specimens are the most important determinant of a false negative urease test.
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Affiliation(s)
- A M Zaitoun
- Department of Pathology, Al Qassimi Hospital, Sharjah, UAE
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8
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Clayton CL, Kleanthous H, Coates PJ, Morgan DD, Tabaqchali S. Sensitive detection of Helicobacter pylori by using polymerase chain reaction. J Clin Microbiol 1992; 30:192-200. [PMID: 1734052 PMCID: PMC265019 DOI: 10.1128/jcm.30.1.192-200.1992] [Citation(s) in RCA: 255] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A polymerase chain reaction (PCR) for the specific detection of Helicobacter pylori was developed with a single primer pair derived from the nucleotide sequence of the urease A gene of H. pylori. We achieved specific amplification of a 411-bp DNA fragment in H. pylori. After 35 cycles of amplification, the product could be detected by agarose gel electrophoresis and contained conserved single HinfI and AluI restriction sites. This fragment was amplified in all 50 strains of H. pylori tested, but it was not detected in other bacterial species, showing the PCR assay to be 100% specific. PCR DNA amplification was able to detect as few as 10 H. pylori cells. PCR detected H. pylori in 15 of 23 clinical human gastric biopsy samples, whereas culturing and microscopy detected H. pylori in only 7 of the samples found to be positive by PCR. Additional primer pairs based on the urease genes enabled the detection of H. pylori in paraffin-embedded human gastric biopsy samples. The detection of H. pylori by PCR will enable both retrospective and prospective analyses of clinical samples, elucidating the role of this organism in gastroduodenal disease.
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Affiliation(s)
- C L Clayton
- Department of Medical Microbiology, St. Bartholomew's Hospital Medical College, London, United Kingdom
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Thillainayagam AV, Arvind AS, Cook RS, Harrison IG, Tabaqchali S, Farthing MJ. Diagnostic efficiency of an ultrarapid endoscopy room test for Helicobacter pylori. Gut 1991; 32:467-9. [PMID: 2040465 PMCID: PMC1378917 DOI: 10.1136/gut.32.5.467] [Citation(s) in RCA: 64] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
There are several reliable methods for detecting Helicobacter pylori but all have as a major disadvantage the time required to yield a definitive result. We have modified the standard urease test so that a positive result is available in one minute. We describe the use of this test in biopsy specimens from the gastric antrum from 220 consecutive patients referred for upper gastrointestinal endoscopy. The performance of the 'one minute test' was compared with a standard urease test, Gram stain, and microbiological culture. Using culture as the 'gold standard' 80 (36%) of the patients were H pylori positive. The one minute test produced no false positives and showed a sensitivity of 89% and specificity of 100%, while the predictive values of a positive and negative test were 100% and 94% respectively. The diagnostic efficiency of the test was 96% compared to 85% for both the Gram stain and direct urease test. All positive results using the one minute test were available within one minute. The test is easy to prepare and costs approximately pounds 0.04. This new modification of the urease test should be superior to the currently available urease tests because a reliable result will be available in almost 90% of infected individuals even before endoscopy is completed.
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Affiliation(s)
- A V Thillainayagam
- Department of Gastroenterology, St Bartholomew's Hospital, West Smithfield, London
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Hernández F, Rivera P, Sigarán M, Miranda J. Diagnosis of Helicobacter pylori: comparison of an urease test, histological visualization of curved bacteria and culture. Rev Inst Med Trop Sao Paulo 1991; 33:80-2. [PMID: 1843403 DOI: 10.1590/s0036-46651991000100015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Helicobacter pylori was investigated in 189 patients for culture, microscopic visualization of campylobacter-like organisms (CLO) and a ten minute urease test. In 136 (72%) the bacteria was isolated, and in 98 of them CLO were histologically detected. Specificity, sensitivity, positive and negative predictive values of microscopic visualization of CLO were: 0.77, 0.73, 0.97 and 0.51, respectively; 98 culture-positive patients were urease test positive. Specificity, sensitivity, positive and negative predictive values of the urease test were: 0.83, 0.72, 0.92 and 0.54, respectively. Comparing the urease test with culture of H. pylori combined with microscopic visualization of CLO, its specificity, sensitivity, positive and negative predictive values were: 0.95, 0.71, 0.98 and 0.48, respectively. Probably, these values are not real, since bacteria different from H. pylori could be misclassified as CLO.
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Affiliation(s)
- F Hernández
- Centro de Investigación y Diagnóstico en Parasitología, Facultad de Microbiología Universidad de Costa Rica, San José
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Sweeney L, Garcia LP, Talbert M, Silverman M, Needham CA. Minitek urea disk test, a sensitive and cost-effective method to screen for Campylobacter pylori in gastric biopsies. J Clin Microbiol 1989; 27:2684-6. [PMID: 2687317 PMCID: PMC267108 DOI: 10.1128/jcm.27.12.2684-2686.1989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
One hundred fifty-five biopsy specimens from the gastric mucosa of 81 patients undergoing routine endoscopy procedures were tested for the presence of Campylobacter pylori by three methods: Gram stain, culture, and modified Minitek, a rapid urea disk test (BBL Microbiology Systems, Cockeysville, Md.). Twenty-nine patients were infected with C. pylori. Sensitivities and specificities of detection were 100 and 94% with the Minitek test and 93 and 100% with Gram stain, respectively. Rapid testing by the urea disk is a simple, cost-effective, and accurate method for detecting the presence of C. pylori in gastric biopsy specimens.
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Affiliation(s)
- L Sweeney
- Department of Laboratory Medicine, Lahey Clinic Medical Center, Burlington, Massachusetts 01805
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12
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Abdalla S, Marco F, Perez RM, Piqué JM, Bordas JM, Jimenez de Anta MT, Teres J. Rapid detection of gastric Campylobacter pylori colonization by a simple biochemical test. J Clin Microbiol 1989; 27:2604-5. [PMID: 2808682 PMCID: PMC267084 DOI: 10.1128/jcm.27.11.2604-2605.1989] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
A simple and rapid urease test to detect Campylobacter pylori infection was evaluated with bacterial culture as the "gold standard." The test was compared with the Gram stain and the conventional Christensen urease test. The culture method detected C. pylori in 29 of 49 gastric biopsy specimens. The rapid urease test showed 27 positive samples within 1 h at 55 degrees C (specificity, 100%; sensitivity, 93%) and 18 at room temperature (specificity, 100%; sensitivity, 62%). The Gram stain exhibited a sensitivity of 86% and a specificity of 91%. The conventional Christensen urease test detected C. pylori in only 4, 10, and 18 samples after 24, 48, and 72 h, respectively (sensitivities, 12, 36, and 60%, respectively; specificities, 95, 95, and 83%, respectively). We conclude that the rapid urease test is simple and highly specific for the detection of C. pylori and that it can be performed with small amounts of sample.
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Affiliation(s)
- S Abdalla
- Gastroenterology Department, Barcelona University, Spain
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Bhasin DK, Singh V, Ayyagari A, Malik AK, Mehta SK. Effect of various anti-ulcer drugs on rapid urease test for Campylobacter pylori infection. Lancet 1989; 2:918-9. [PMID: 2571835 DOI: 10.1016/s0140-6736(89)91577-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Bhasin D, Yachha S, Ayyagiri A, Singh V, Kochhar R, Malik A, Mehta S. How specific is the rapid urease test for diagnosing Campylobacter pylori? J Clin Pathol 1989; 42:671. [PMID: 2661596 PMCID: PMC1142006 DOI: 10.1136/jcp.42.6.671-a] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Negrini R, Lisato L, Cavazzini L, Maini P, Gullini S, Basso O, Lanza G, Garofalo M, Nenci I. Monoclonal antibodies for specific immunoperoxidase detection of Campylobacter pylori. Gastroenterology 1989; 96:414-20. [PMID: 2642876 DOI: 10.1016/0016-5085(89)91565-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Monoclonal antibodies were raised against Campylobacter pylori to detect the organism in clinical specimens by the immunoperoxidase technique. Twenty-one hybridoma cultures obtained were screened on tissue sections of gastric mucosa to identify antibodies that did not cross-react with host cells. To select antibodies with high grade of specificity to C. pylori, hybridomas were also screened by an enzyme-linked immunosorbent assay against a wide panel of gram-negative bacteria. Fifteen antibodies showed a variable grade of cross-reactivity with gastric mucosa, indicating the presence of at least three epitopes shared by C. pylori and epithelial cells. Three of the six antibodies non-reacting with gastric mucosa (CB-1, CB-26, and CB-31) also were found to be specific for C. pylori. Using CB-26 in an indirect immunoperoxidase test, gastric brushings from 60 patients consecutively undergoing endoscopic examination were examined. By light microscopy, we observed the presence of large amounts of C. pylori in smears from all the 32 patients with positive culture. A small number of bacterial cells were also seen in 8 of 28 patients whose cultures were negative. These findings suggest that the monoclonal antibody CB-26 might be of value for rapid and specific detection of C. pylori.
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Affiliation(s)
- R Negrini
- Istituto di Anatomia e Istologia Patologica, Universitá di Ferrara, Italy
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Westblom TU, Madan E, Kemp J, Subik MA. Evaluation of a rapid urease test to detect Campylobacter pylori infection. J Clin Microbiol 1988; 26:1393-4. [PMID: 3410949 PMCID: PMC266616 DOI: 10.1128/jcm.26.7.1393-1394.1988] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Seventy-five consecutive patients referred for upper gastrointestinal tract endoscopy were evaluated for Campylobacter pylori infection by pathology, culture, and a biochemical test to detect bacterial urease. Forty-eight patients (64%) had C. pylori present based on pathology or culture or both. Thirty-two urease tests were positive after 1 h, all in patients with C. pylori detected by the two other methods (specificity, 100%; sensitivity, 67%). After 24 h, 47 urease tests were positive, but only 40 had C. pylori present (specificity, 74%; sensitivity, 83%). When read after 1 h, the urease test was highly specific and led to rapid presumptive diagnosis.
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Affiliation(s)
- T U Westblom
- Section of Infectious Diseases, Marshall University School of Medicine, Veterans Administration Medical Center, Huntington, West Virginia 25701-5490
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Vaira D, Holton J, Cairns S, Falzon M, Salmon P. Four hour rapid urease test (RUT) for detecting Campylobacter pylori: is it reliable enough to start treatment? J Clin Pathol 1988; 41:355-6. [PMID: 3283175 PMCID: PMC1141442 DOI: 10.1136/jcp.41.3.355-b] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Tytgat GN, Rauws EA, De Koster E. Campylobacter pylori. SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY. SUPPLEMENT 1988; 155:68-81. [PMID: 3072666 DOI: 10.3109/00365528809096287] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Worldwide Campylobacter pylori is a major cause of active chronic gastritis in man. This curved spiraled microorganism can readily be detected within the mucusgel especially in the antrum, in particular in patients suffering from peptic ulcer disease or non-ulcer dyspepsia, rarely in individuals with normal gastroduodenal mucosa. Increasingly arguments are being presented in support of a pathogenetic role of C. pylori in non-ulcer dyspepsia and in peptic ulcer disease. There is a striking discordance between in vitro antibiotic sensitivity, and in vivo efficacy with respect to suppression or eradication of the organism. At present the combination of colloidal bismuth subcitrate and amoxicilline or tinidazole appears to be encouraging with respect to longterm eradication of this peculiar microorganism. Eradication by antibacterial treatment ultimately may result in histologic normalization of the gastric mucosa. To what extent peptic ulcer disease. There is a striking discordance between in vitro antibiotic sensitivity, and in.
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Affiliation(s)
- G N Tytgat
- Division Gastroenterology Hepatology, Academi Medical Centre, Amsterdam, The Netherlands
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