Usefulness of culture, histology, and urease testing in the detection of Campylobacter pylori.

Several tests have been described which detect the presence of Campylobacter pylori (CP) in the human upper gastrointestinal tract. Antral biopsies from 160 endoscopies were evaluated for the presence of CP; four tests readily available to the practicing endoscopist were used: two urease tests [CLOtest and microtiter biopsy urease test (MBUT)], hematoxylin and eosin staining, and culture. Sensitivity and specificity of each was evaluated and found to be near 90%, except for culture, which was less sensitive. The presence of peptic disease on endoscopy, and age greater than 50 yr, did play a small role in the sensitivity and specificity of the tests. With the advantage of lower cost, ease, and rapidity of performance, either the CLOtest or MBUT is recommended for the standard endoscopic evaluation for CP.