Skip to main content
NCBI home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1994 Jul;32(7):1663–1668. doi: 10.1128/jcm.32.7.1663-1668.1994

Comparison of PCR and other diagnostic techniques for detection of Helicobacter pylori infection in dyspeptic patients.

J Weiss 1, J Mecca 1, E da Silva 1, D Gassner 1
PMCID: PMC263756  PMID: 7929755

Abstract

A sensitive and specific PCR-based assay to detect the Helicobacter pylori 16S rRNA gene present in formalin-fixed paraffin-embedded gastric biopsy specimens has been developed. A total of 95 patients with dyspepsia were evaluated for the presence of chronic active gastritis and an infection with H. pylori through the use of diagnostic assays based on biopsy specimens and serology. The "gold standard" for the presence of the bacteria was direct detection in histological sections of biopsy specimens by Giemsa stain. The results obtained with the PCR assay performed on the biopsy specimens (94% sensitivity and 100% specificity) were equivalent to the detection of H. pylori immunoglobulin G antibodies by the commercially available second-generation Cobas Core anti-H. pylori immunoglobulin G enzyme immunoassay (94% sensitivity and 98% specificity) for the diagnosis of H. pylori infection. Urease testing and bacterial culture of the biopsy specimens were inferior (88 and 70% sensitivity and 96% and 98% specificity, respectively). A Western blot (immunoblot) analysis had slightly greater sensitivity (96%), although specificity was reduced to 93%. This research prototype PCR assay was shown to be highly reliable for the detection of infection with H. pylori and the presence of chronic active gastritis in the population studied.

Full text

PDF
1663

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Akopyanz N., Bukanov N. O., Westblom T. U., Berg D. E. PCR-based RFLP analysis of DNA sequence diversity in the gastric pathogen Helicobacter pylori. Nucleic Acids Res. 1992 Dec 11;20(23):6221–6225. doi: 10.1093/nar/20.23.6221. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Berstad K., Berstad A. Helicobacter pylori infection in peptic ulcer disease. Scand J Gastroenterol. 1993 Jul;28(7):561–567. doi: 10.3109/00365529309096088. [DOI] [PubMed] [Google Scholar]
  3. Clayton C. L., Kleanthous H., Coates P. J., Morgan D. D., Tabaqchali S. Sensitive detection of Helicobacter pylori by using polymerase chain reaction. J Clin Microbiol. 1992 Jan;30(1):192–200. doi: 10.1128/jcm.30.1.192-200.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Clayton C. L., Kleanthous H., Morgan D. D., Puckey L., Tabaqchali S. Rapid fingerprinting of Helicobacter pylori by polymerase chain reaction and restriction fragment length polymorphism analysis. J Clin Microbiol. 1993 Jun;31(6):1420–1425. doi: 10.1128/jcm.31.6.1420-1425.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Engstrand L., Nguyen A. M., Graham D. Y., el-Zaatari F. A. Reverse transcription and polymerase chain reaction amplification of rRNA for detection of Helicobacter species. J Clin Microbiol. 1992 Sep;30(9):2295–2301. doi: 10.1128/jcm.30.9.2295-2301.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Foxall P. A., Hu L. T., Mobley H. L. Use of polymerase chain reaction-amplified Helicobacter pylori urease structural genes for differentiation of isolates. J Clin Microbiol. 1992 Mar;30(3):739–741. doi: 10.1128/jcm.30.3.739-741.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Glupczynski Y., Burette A., Goossens H., DePrez C., Butzler J. P. Effect of antimicrobial therapy on the specific serological response to Helicobacter pylori infection. Eur J Clin Microbiol Infect Dis. 1992 Jul;11(7):583–588. doi: 10.1007/BF01961663. [DOI] [PubMed] [Google Scholar]
  8. Goossens H., Glupczynski Y., Burette A., Van den Borre C., Butzler J. P. Evaluation of a commercially available second-generation immunoglobulin G enzyme immunoassay for detection of Helicobacter pylori infection. J Clin Microbiol. 1992 Jan;30(1):176–180. doi: 10.1128/jcm.30.1.176-180.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Graham D. Y., Go M. F. Helicobacter pylori: current status. Gastroenterology. 1993 Jul;105(1):279–282. doi: 10.1016/0016-5085(93)90038-e. [DOI] [PubMed] [Google Scholar]
  10. Granberg C., Mansikka A., Lehtonen O. P., Kujari H., Grönfors R., Nurmi H., Räihä I., Ståhlberg M. R., Leino R. Diagnosis of Helicobacter pylori infection by using pyloriset EIA-G and EIA-A for detection of serum immunoglobulin G (IgG) and IgA antibodies. J Clin Microbiol. 1993 Jun;31(6):1450–1453. doi: 10.1128/jcm.31.6.1450-1453.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Greer C. E., Peterson S. L., Kiviat N. B., Manos M. M. PCR amplification from paraffin-embedded tissues. Effects of fixative and fixation time. Am J Clin Pathol. 1991 Feb;95(2):117–124. doi: 10.1093/ajcp/95.2.117. [DOI] [PubMed] [Google Scholar]
  12. Hammar M., Tyszkiewicz T., Wadström T., O'Toole P. W. Rapid detection of Helicobacter pylori in gastric biopsy material by polymerase chain reaction. J Clin Microbiol. 1992 Jan;30(1):54–58. doi: 10.1128/jcm.30.1.54-58.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hentschel E., Brandstätter G., Dragosics B., Hirschl A. M., Nemec H., Schütze K., Taufer M., Wurzer H. Effect of ranitidine and amoxicillin plus metronidazole on the eradication of Helicobacter pylori and the recurrence of duodenal ulcer. N Engl J Med. 1993 Feb 4;328(5):308–312. doi: 10.1056/NEJM199302043280503. [DOI] [PubMed] [Google Scholar]
  14. Ho S. A., Hoyle J. A., Lewis F. A., Secker A. D., Cross D., Mapstone N. P., Dixon M. F., Wyatt J. I., Tompkins D. S., Taylor G. R. Direct polymerase chain reaction test for detection of Helicobacter pylori in humans and animals. J Clin Microbiol. 1991 Nov;29(11):2543–2549. doi: 10.1128/jcm.29.11.2543-2549.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Hoek F. J., Noach L. A., Rauws E. A., Tytgat G. N. Evaluation of the performance of commercial test kits for detection of Helicobacter pylori antibodies in serum. J Clin Microbiol. 1992 Jun;30(6):1525–1528. doi: 10.1128/jcm.30.6.1525-1528.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Hoshina S., Kahn S. M., Jiang W., Green P. H., Neu H. C., Chin N., Morotomi M., LoGerfo P., Weinstein I. B. Direct detection and amplification of Helicobacter pylori ribosomal 16S gene segments from gastric endoscopic biopsies. Diagn Microbiol Infect Dis. 1990 Nov-Dec;13(6):473–479. doi: 10.1016/0732-8893(90)90079-b. [DOI] [PubMed] [Google Scholar]
  17. Kosunen T. U., Seppälä K., Sarna S., Sipponen P. Diagnostic value of decreasing IgG, IgA, and IgM antibody titres after eradication of Helicobacter pylori. Lancet. 1992 Apr 11;339(8798):893–895. doi: 10.1016/0140-6736(92)90929-w. [DOI] [PubMed] [Google Scholar]
  18. Lelwala-Guruge J., Nilsson I., Ljungh A., Wadström T. Cell surface proteins of Helicobacter pylori as antigens in an ELISA and a comparison with three commercial ELISA. Scand J Infect Dis. 1992;24(4):457–465. doi: 10.3109/00365549209052632. [DOI] [PubMed] [Google Scholar]
  19. Loeffelholz M. J., Lewinski C. A., Silver S. R., Purohit A. P., Herman S. A., Buonagurio D. A., Dragon E. A. Detection of Chlamydia trachomatis in endocervical specimens by polymerase chain reaction. J Clin Microbiol. 1992 Nov;30(11):2847–2851. doi: 10.1128/jcm.30.11.2847-2851.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Mapstone N. P., Lynch D. A., Lewis F. A., Axon A. T., Tompkins D. S., Dixon M. F., Quirke P. PCR identification of Helicobacter pylori in faeces from gastritis patients. Lancet. 1993 Feb 13;341(8842):447–447. doi: 10.1016/0140-6736(93)93053-4. [DOI] [PubMed] [Google Scholar]
  21. Nomura A., Stemmermann G. N., Chyou P. H., Kato I., Perez-Perez G. I., Blaser M. J. Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii. N Engl J Med. 1991 Oct 17;325(16):1132–1136. doi: 10.1056/NEJM199110173251604. [DOI] [PubMed] [Google Scholar]
  22. Parsonnet J., Friedman G. D., Vandersteen D. P., Chang Y., Vogelman J. H., Orentreich N., Sibley R. K. Helicobacter pylori infection and the risk of gastric carcinoma. N Engl J Med. 1991 Oct 17;325(16):1127–1131. doi: 10.1056/NEJM199110173251603. [DOI] [PubMed] [Google Scholar]
  23. Price A. B. The Sydney System: histological division. J Gastroenterol Hepatol. 1991 May-Jun;6(3):209–222. doi: 10.1111/j.1440-1746.1991.tb01468.x. [DOI] [PubMed] [Google Scholar]
  24. Schembri M. A., Lin S. K., Lambert J. R. Comparison of commercial diagnostic tests for Helicobacter pylori antibodies. J Clin Microbiol. 1993 Oct;31(10):2621–2624. doi: 10.1128/jcm.31.10.2621-2624.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Thomas J. E., Gibson G. R., Darboe M. K., Dale A., Weaver L. T. Isolation of Helicobacter pylori from human faeces. Lancet. 1992 Nov 14;340(8829):1194–1195. doi: 10.1016/0140-6736(92)92894-l. [DOI] [PubMed] [Google Scholar]
  26. Valentine J. L., Arthur R. R., Mobley H. L., Dick J. D. Detection of Helicobacter pylori by using the polymerase chain reaction. J Clin Microbiol. 1991 Apr;29(4):689–695. doi: 10.1128/jcm.29.4.689-695.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Wang J. T., Lin J. T., Sheu J. C., Yang J. C., Chen D. S., Wang T. H. Detection of Helicobacter pylori in gastric biopsy tissue by polymerase chain reaction. Eur J Clin Microbiol Infect Dis. 1993 May;12(5):367–371. doi: 10.1007/BF01964436. [DOI] [PubMed] [Google Scholar]
  28. Weiss J. B., van Keulen H., Nash T. E. Classification of subgroups of Giardia lamblia based upon ribosomal RNA gene sequence using the polymerase chain reaction. Mol Biochem Parasitol. 1992 Aug;54(1):73–86. doi: 10.1016/0166-6851(92)90096-3. [DOI] [PubMed] [Google Scholar]
  29. Westblom T. U., Phadnis S., Yang P., Czinn S. J. Diagnosis of Helicobacter pylori infection by means of a polymerase chain reaction assay for gastric juice aspirates. Clin Infect Dis. 1993 Mar;16(3):367–371. doi: 10.1093/clind/16.3.367. [DOI] [PubMed] [Google Scholar]
  30. van Zwet A. A., Thijs J. C., Kooistra-Smid A. M., Schirm J., Snijder J. A. Sensitivity of culture compared with that of polymerase chain reaction for detection of Helicobacter pylori from antral biopsy samples. J Clin Microbiol. 1993 Jul;31(7):1918–1920. doi: 10.1128/jcm.31.7.1918-1920.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. von Wulffen H. An assessment of serological tests for detection of Helicobacter pylori. Eur J Clin Microbiol Infect Dis. 1992 Jul;11(7):577–582. doi: 10.1007/BF01961662. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES