Comparison of the clinical feasibility of three rapid urease tests in the diagnosis of Helicobacter pylori infection.

Rapid urease tests (RUTs) are a fast, accurate, and inexpensive method to diagnose H. pylori infection in the endoscopy suite. Of these, the CLO test is both common and widely used. The aim of our study was to evaluate the accuracy and positive reaction times of two new rapid urease tests (ProntoDry and HpONE) in comparison with the CLO test. Fifty-one patients (26 men, 25 women; mean age, 52.4 years) were included in this study, and all underwent esophagogastroduodenoscopy (EGD). None of the patients had received any prior H. pylori eradication therapy. H. pylori infection status was evaluated by histology, culture, 13C-UBT, and RUT. H. pylori infection was considered to be positive if the culture was positive or if two of the other three tests (histology, RUT, and 13C-UBT) were positive. If culture was negative and only one of the other three tests was positive, or if all four tests were negative, the result was interpreted as negative. Of these 51 patients, 2 were excluded and 29 (59.1%) were infected with H. pylori. The sensitivities, specificities, positive predictive values, and negative predictive values of the three RUTs were not significantly different. The mean positive reaction times of the three RUTs (CLO test, ProntoDry, and HpONE) were 67.8+/-12.0, 16.5+/-2.2, and 17.8+/-2.1 min, respectively. ProntoDry (P < 0.001) and HpONE (P < 0.001) had significantly faster reaction times than the CLO test, but there was no significant difference between ProntoDry and HpONE. Different media of RUTs may influence the rapidity of a positive reaction time. Both ProntoDry and HpONE were superior to the CLO test in terms of accuracy, reaction time, and cost-effectiveness.