title: Multiplex PCR for detection of Helicobacter pylori infection in gastric biopsies with lower inflammatory score.
abstract: BACKGROUND
  No gold standard has yet been established for the diagnosis of H. pylori infection. A multiplex polymerase chain reaction (mPCR) was developed in this study for rapid, sensitive and specific detection of H. pylori from gastric biopsies.
  
  
  METHODS
  H. pylori infections were determined by in-house rapid urease test (iRUT), culture, histology and multiplex PCR.
  
  
  RESULTS
  A total of 140 (60.9%) from 230 patients were positive for H. pylori infection. H. pylori were detected in 9.6% (22/230), 17% (39/230), 12.6% (29/230) and 60% (138/230) of biopsy specimens by culture, iRUT, histology and mPCR, respectively. mPCR identified H. pylori infection in 100% of biopsies with positive histology and culture. All biopsies with positive iRUT yielded positive PCR except two cases. mPCR also detected H. pylori in additional 116, 101 and 109 biopsies that were negative by culture, iRUT and histology, respectively. Positive samples by mPCR showed lower average in H. pylori density, activity and inflammation scores. The Indians showed the highest prevalence of H. pylori infection compared to the Chinese and the Malays. In addition, Chinese patients with older age were significantly infected compared to other ethnicities.
  
  
  CONCLUSIONS
  PCR was able to detect the highest numbers of positive cases although the lowest average scores were recorded in the activity, inflammatory and H. pylori density.
authors.affiliation: a Faculty of Medicine, Department of Medical Microbiology and Immunology , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia.
authors.forename: Najmiyatul
authors.initials: N
authors.lastname: Fadilah
authors.affiliation: a Faculty of Medicine, Department of Medical Microbiology and Immunology , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia.
authors.forename: Alfizah
authors.initials: A
authors.lastname: Hanafiah
authors.affiliation: b Medicine, Faculty of Medicine , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia.
authors.forename: Hamizah
authors.initials: H
authors.lastname: Razlan
authors.affiliation: b Medicine, Faculty of Medicine , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia.
authors.forename: Zin Qin
authors.initials: ZQ
authors.lastname: Wong
authors.affiliation: c Pathology, Faculty of Medicine , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia.
authors.forename: Isa
authors.initials: I
authors.lastname: Mohamed Rose
authors.affiliation: a Faculty of Medicine, Department of Medical Microbiology and Immunology , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia.
authors.forename: Md Mostafizur
authors.initials: MM
authors.lastname: Rahman
mesh_terms: D018829:Adhesins, Bacterial / Q000235:genetics; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D004279:DNA, Viral / Q000032:analysis*; D005240:Feasibility Studies; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000235:genetics* / Q000378:metabolism / Q000502:physiology; D054884:Host-Pathogen Interactions; D006801:Humans; D008297:Male; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction / Q000379:methods*; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013270:Stomach / Q000382:microbiology / Q000473:pathology; D014510:Urease / Q000378:metabolism; D055815:Young Adult
chemical_list: D018829:Adhesins, Bacterial; D004279:DNA, Viral; D012336:RNA, Ribosomal, 16S; C095977:adhesin A, Helicobacter; D014510:Urease
keywords: Helicobacter pylori; diagnosis; inflammatory scores; multiplex PCR