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    Comparison of culture, Real- time-PCR, ELISA, and histopathological examination methods for identification of Helicobacter pylori
    (2018) Maçin, Salih; Alp, Alpaslan; Şener, Burçin; Sökmensüer, Cenk; Orhan, Diclehan; Özen, Hasan; Kav, Taylan
    Introduction: There are several methods used for the diagnosis of Helicobacterpylori infections, and there is an increasing demand for theuse of non-invasive, more rapid tests. The aim of the present study wasto compare different diagnostic methods.Methods: A total of 87 patients who had undergone esophagogastroduodenoscopywere included in the study. Biopsy samples obtainedfrom these patients were used for culture, real-time polymerase chainreaction (RT-PCR), and histopathological examination. Stool sampleswere also collected from these patients and were tested using the Helicobacterpylori stool antigen (HpSA) kit. Histopathological examinationwas accepted as the gold standard test.Results: H. pylori was identified by histological examination in 77/87(87.5%) patients, whereas it was negative in 10/87 (12.5%) patients. Furthermore,positive results were obtained in 55 (63.2%), 71 (81.6%), and 77(87.5%) patients using the culture method, HpSA analysis, and RT-PCR method,respectively. The sensitivity and specificity of culture, HpSA, and PCRtests were determined as 71.4% and 100%, 87% and 60%, and 97.4% and80%, respectively. Antibiotic susceptibility tests were performed on 48 outof the 55 culture positive samples. Resistance to clarithromycin was foundin 28 (58.3%), metronidazole in 14 (29.2%), and levofloxacin in 4 (8.3%) ofthe isolates. Resistance to amoxicillin and tetracycline was not observed.Conclusion: There are currently several invasive and non-invasive diagnostictests for the detection of H. pylori infections. Each test has someadvantages and disadvantages. The diagnostic method of choice shouldbe easy and applicable to all age groups.