title: How accurate is the culture of Helicobacter pylori in a clinical setting? An appraisal.
abstract: OBJECTIVE
  The trend towards increasing prevalence of Helicobacter pylori (H. pylori) antibiotic resistance may jeopardize the efficacy of most regimens. Culture of the bacterium, the useful method able to address therapy, is influenced by various factors. Thus, validation of the procedure is fundamental. Most studies have been carried out in microbiological settings, while only few have been conducted in clinical frames. We evaluated the accuracy of culture for detection of H. pylori in a clinical dedicated laboratory.
  
  
  METHODS
  Forty-six patients (28 females, 18 males, mean age 56+/-4.7 years) were included. Thirty experienced failure to H. pylori eradication after at least 3 courses of treatment. The control group included 16 subjects suffering from gastroesophageal reflux disease and negativity for H. pylori infection. Diagnostic strategy was based on histology, culture testing, serology and 13C-urea breath test. A patient was considered infected if 2 tests were positive. A commercial culture medium in microaerophilic atmosphere was utilized.
  
  
  RESULTS
  Out of 30 positive specimens, culture correctly identified 29. In 1 case, no growth of micro-organisms occurred. In the control group, bacterial culture accurately identified all negative samples. One of them indicated growth but neither aspect nor confirmation tests identified H. pylori. Sensitivity was 96.7%, specificity 100%, and accuracy 97.8%. Positive and negative predictive values were 100% and 94.1%, respectively.
  
  
  CONCLUSIONS
  Culture of H. pylori is a feasible method and provides a good level of diagnostic accuracy even in a clinical setting by following international guidelines combined with training of specialized personnel.
authors.affiliation: Department of Gastro-Hepatology, Molinette Hospital, Turin, Italy. rinaldo_pellican@hotmail.com
authors.forename: R
authors.initials: R
authors.lastname: Pellicano
authors.forename: A
authors.initials: A
authors.lastname: Smedile
authors.forename: A
authors.initials: A
authors.lastname: Ponzetto
authors.forename: M
authors.initials: M
authors.lastname: Berrutti
authors.forename: M
authors.initials: M
authors.lastname: Astegiano
authors.forename: G
authors.initials: G
authors.lastname: Saracco
authors.forename: C
authors.initials: C
authors.lastname: De Angelis
authors.forename: A
authors.initials: A
authors.lastname: Repici
authors.forename: A
authors.initials: A
authors.lastname: Morgando
authors.forename: M L
authors.initials: ML
authors.lastname: Abate
authors.forename: S
authors.initials: S
authors.lastname: Fagoonee
authors.forename: M
authors.initials: M
authors.lastname: Rizzetto
mesh_terms: D001944:Breath Tests / Q000379:methods*; D002247:Carbon Isotopes; D005260:Female; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014508:Urea / Q000378:metabolism*
chemical_list: D002247:Carbon Isotopes; D014508:Urea