Evaluation of invasive and noninvasive diagnostic methods of helicobacter pylori infection in endoscopic biopsy samples of dyspeptic patients: a rural hospital based study

Introduction: The identification of the clinical consequences of Helicobacter pylori infection is certainly one of the major discoveries within the past 20 years in medicine. H. pylori was the first formally recognized bacterial carcinogen and is one of the most common human pathogen. It has been etiologically associated with gastritis and gastric associated diseases, peptic ulcer, gastric adenocarcinoma and primary gastric carcinoma. Dyspepsia is a very common group of symptoms referring upper gastrointestinal tract for which patients consult the physician, accounting for about 4% to 14% of their consultations. Annual Incidence of Helicobacter pylori is 6%-14% in developing countries with faeco-oral route of transmission. In this context this study has been undertaken to look for the association of H. pylori in adult patients of dyspepsia with evaluation of diagnostic test for detection of H. pylori in dyspeptic patients visiting in a tertiary hospital in a rural setup of central India. Material and Methods: It was a cross sectional studies involving 52 patients. After obtaining history and written informed consent, 4 antral mucosal biopsy specimens were collected along with 5 ml blood sample. Biopsy specimens were subjected to Rapid urea test (RUT), Culture, Gram staining and Histopathological examination. Subculture from Brucella broth was done on Brucella chocolate agar with & without antibiotics. Identification was done by standard tests. Serum was separated and used for ELISA test for H. pylori IgG antibody. Results: Out of the 52 patients studied, 25 (48.07%) were positive by Rapid urease test, 20(38.46%) by Gram staining, 17(32.69%) by Culture, 21(40.38%) by Histopathology and IgG 28(53.84%) by ELISA test. RUT had 100% sensitivity and 77.14% specificity, while histopathology had 94.11% sensitivity and 85.14% specificity and IgG had 94.11% sensitivity and 65.71% specificity in reference to culture. Conclusion: In our study, we have revealed that for diagnosing H. pylori either one can use RUT for rapid diagnosis in the endoscopic room itself and confirm diagnosis by culture or histopathology.