title: Dual specimens increase the diagnostic accuracy and reduce the reaction duration of rapid urease test.
abstract: OBJECTIVE
  To evaluate the influence of multiple samplings during esophagogastroduodenoscopy (EGD) on the accuracy of the rapid urease test, and the validity of newly developed rapid urease tests, HelicotecUT plus test and HelicotecUT test, CLO test and ProntoDry test.
  
  
  METHODS
  A total of 355 patients undergoing EGD for dyspepsia were included. Their Helicobacter pylori (H. pylori) treatment status was either naïve or eradicated. Six biopsy specimens from antrum and gastric body, respectively, were obtained during EGD. Single antral specimens and dual (antrum + body) specimens were compared. Infection status of H. pylori was evaluated by three different tests: culture, histology, and four different commercially available rapid urease tests (RUTs)-including the newly developed HelicotecUT plus test and HelicotecUT test, and established CLO test and ProntoDry test. H. pylori status was defined as positive when the culture was positive or if there were concordant positive results among histology, CLO test and ProntoDry test.
  
  
  RESULTS
  When dual specimens were applied, sensitivity was enhanced and RUT reaction time was significantly reduced, regardless of their treatment status. Thirty minutes were enough to achieve an agreeable positive rate in all the RUTs. Both newly developed RUTs showed comparable sensitivity, specificity and accuracy to the established RUTs, regardless of patient treatment status, RUT reaction duration, and EGD biopsy sites.
  
  
  CONCLUSIONS
  Combination of antrum and body biopsy specimens greatly enhances the sensitivity of rapid urease test and reduces the reaction duration to 30 min.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan, China.
authors.forename: Wen-Hung
authors.initials: WH
authors.lastname: Hsu
authors.forename: Sophie-Sw
authors.initials: SS
authors.lastname: Wang
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Kuo
authors.forename: Chiao-Yun
authors.initials: CY
authors.lastname: Chen
authors.forename: Ching-Wen
authors.initials: CW
authors.lastname: Chang
authors.forename: Huang-Ming
authors.initials: HM
authors.lastname: Hu
authors.forename: Jaw-Yuan
authors.initials: JY
authors.lastname: Wang
authors.forename: Yuan-Chieh
authors.initials: YC
authors.lastname: Yang
authors.forename: Yu-Chun
authors.initials: YC
authors.lastname: Lin
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Wang
authors.forename: Deng-Chyang
authors.initials: DC
authors.lastname: Wu
authors.forename: Ming-Tsang
authors.initials: MT
authors.lastname: Wu
authors.forename: Fu-Chen
authors.initials: FC
authors.lastname: Kuo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016145:Endoscopy, Digestive System; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000201:enzymology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000201:enzymology / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011933:Reagent Kits, Diagnostic; D015203:Reproducibility of Results; D014510:Urease / Q000378:metabolism*; D055815:Young Adult
chemical_list: D011933:Reagent Kits, Diagnostic; D014510:Urease