title: Molecular Detection of H. pylori Using Adherent Gastric Mucous to Biopsy Forceps.
abstract: OBJECTIVE
  We assessed whether adherent gastric mucous to biopsy forceps instead of biopsy samples was suitable for the diagnosis of H. pylori infection. We confirmed the PCR methods to improve the diagnosis of H. pylori infection and clarithromycin (CAM) susceptibility.
  
  
  METHODS
  Gastric mucous was obtained by gently scraping gastric mucosa using biopsy forceps in patients undergoing upper gastrointestinal (GI) endoscopy for PCR and rapid urease test (RUT). DNA was extracted from gastric mucous present within the gel of RUT. H. pylori status and CAM susceptibility were evaluated using H. pylori-specific PCR amplification for 23S rRNA using 4 different primer sets and 16S rRNA. H. pylori positive was defined as two of the three tests (serum antibody, histology, and RUT or PCR) were positive. CAM susceptibility was evaluated by point mutations (A 2142G and A 2143G of 23S rRNA).
  
  
  RESULTS
  Samples taken from 494 subjects were evaluated: 300 H. pylori-positive patients and 194 negative patients. The results of PCR using DNA extracted from gastric mucous present within the RUT gel were consistent with those within water. The accuracy of 23S rRNA PCR for H. pylori detection using RUT samples was superior to the other tests. The frequency of CAM resistance was 38.9%, and eradication rate was 91.3% in the patients with wild-type and 47.0% in the patients with the mutant strains.
  
  
  CONCLUSIONS
  Adherent gastric mucous to biopsy forceps in RUT gel can be used for molecular testing to confirm the diagnosis of H. pylori infection and for CAM susceptibility.
authors.affiliation: Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsumoto
authors.affiliation: Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Shiotani
authors.affiliation: Department of Gastroenterology and Hepatology, Kawanishi Municipal Hospital, Hyogo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishibayashi
authors.affiliation: Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan.
authors.forename: Tomoari
authors.initials: T
authors.lastname: Kamada
authors.affiliation: Department of Gastroenterology, Sakakibara Heart Institute of Okayama, Okayama, Japan.
authors.forename: Tomonari
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Gastroenterology, Sakakibara Heart Institute of Okayama, Okayama, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Fujimura
authors.affiliation: Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan.
authors.forename: Rui
authors.initials: R
authors.lastname: Nakato
authors.affiliation: Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Murao
authors.affiliation: Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Fujita
authors.affiliation: Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001706:Biopsy; D017291:Clarithromycin / Q000494:pharmacology; D017931:DNA Primers / Q000235:genetics; D004269:DNA, Bacterial / Q000235:genetics / Q000302:isolation & purification; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D009093:Mucus / Q000382:microbiology*; D017354:Point Mutation; D016133:Polymerase Chain Reaction / Q000379:methods; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012338:RNA, Ribosomal, 23S / Q000235:genetics; D013048:Specimen Handling / Q000379:methods*; D013525:Surgical Instruments / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D017931:DNA Primers; D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S; D012338:RNA, Ribosomal, 23S; D017291:Clarithromycin
keywords: 16s rDNA; Gastric mucin; clarithromycin resistance; rapid urease test