Evaluation of urease test, gram stain, culture, and histology in the detection of Campylobacter pylori.

To evaluate the commonly available tests for detection of Campylobacter pylori infection in the human stomach, we prospectively performed endoscopy and biopsy from the antrum of the stomach in 121 consecutive patients. Four tests, including the urease test, Gram stain, culture, and the hematoxylin and eosin (H & E) stain were used to detect the presence of C. pylori. A C. pylori positive was defined by a positive culture or positive results in two of the other three tests. The sensitivity of the urease test, Gram stain, culture, and H & E stain was 95%, 95%, 71%, and 97%, respectively, and the specificity of those tests was 96%, 100%, 100%, and 73%, respectively. For diagnosis, theoretically, all four tests should be performed from the biopsy specimens. In our experience, the culture was less sensitive, and the H & E stain was less specific, while the urease test and Gram stain were more rapid and had high sensitivity and specificity in the detection of C. pylori infection.