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Abstract
Background: No gold standard has yet been established for the diagnosis of H. pylori infection. A multiplex polymerase chain reaction (mPCR) was developed in this study for rapid, sensitive and specific detection of H. pylori from gastric biopsies.
Methods: H. pylori infections were determined by in-house rapid urease test (iRUT), culture, histology and multiplex PCR.
Results: A total of 140 (60.9%) from 230 patients were positive for H. pylori infection. H. pylori were detected in 9.6% (22/230), 17% (39/230), 12.6% (29/230) and 60% (138/230) of biopsy specimens by culture, iRUT, histology and mPCR, respectively. mPCR identified H. pylori infection in 100% of biopsies with positive histology and culture. All biopsies with positive iRUT yielded positive PCR except two cases. mPCR also detected H. pylori in additional 116, 101 and 109 biopsies that were negative by culture, iRUT and histology, respectively. Positive samples by mPCR showed lower average in H. pylori density, activity and inflammation scores. The Indians showed the highest prevalence of H. pylori infection compared to the Chinese and the Malays. In addition, Chinese patients with older age were significantly infected compared to other ethnicities.
Conclusion: PCR was able to detect the highest numbers of positive cases although the lowest average scores were recorded in the activity, inflammatory and H. pylori density.
Acknowledgements
We thank the Universiti Kebangsaan Malaysia for providing both the permission and the facilities to conduct and publish this research. This study was supported by a grant from the university (UKM-GUP-2011-307). We are also grateful to all of the staffs of the Endoscopy Unit, Histopathology Unit and Department of Medical Microbiology & Immunology at the Universiti Kebangsaan Malaysia Medical Centre for their technical help.