Clinical Trials Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2015; 21(3): 944-952
Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.944
Centralized isolation of Helicobacter pylori from multiple centers and transport condition influences
Ya-Nan Gong, You-Ming Li, Ning-Min Yang, Hong-Zhang Li, Feng Guo, Lang Lin, Qun-Ying Wang, Jia-Kun Zhang, Zi-Zhong Ji, Ji-Bo Mao, Jun-Liang Mao, Zheng-Chao Shi, Wu-Heng Tang, Xin-Jian Zhu, Wei Shao, Xiao-Feng Zhang, Xing-Hua Wang, Yue-Feng Tong, Mi-Zu Jiang, Guang-Lan Chen, Zhi-Yong Wang, Hui-Min Tu, Guo-Fa Jiang, Jian-Sheng Wu, Xu-Peng Chen, Qiu-Long Ding, Hong Ouyang, Feng-Zhe Jin, Yan-Li Xu, Jian-Zhong Zhang
Ya-Nan Gong, Jian-Zhong Zhang, State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Ya-Nan Gong, Jian-Zhong Zhang, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, Zhejiang Province, China
You-Ming Li, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Ning-Min Yang, Zhiyuan Medical Inspection Institute Co., Ltd., Hangzhou 310021, Zhejiang Province, China
Hong-Zhang Li, Sanmen People’s Hospital, Taizhou 317100, Zhejiang Province, China
Feng Guo, The First People’s Hospital of Xiaoshan District, Hangzhou 311200, Zhejiang Province, China
Lang Lin, The First People’s Hospital of Cangnan, Wenzhou 325800, Zhejiang Province, China
Qun-Ying Wang, Jinhua Municipal Central Hospital, Jinhua 321001, Zhejiang Province, China
Jia-Kun Zhang, The First People’s Hospital of Pingyang, Wenzhou 325400, Zhejiang Province, China
Zi-Zhong Ji, The First Hospital of Jiaxing, Jiaxing 314001, Zhejiang Province, China
Ji-Bo Mao, Zhoushan Hospital, Zhoushan 316021, Zhejiang Province, China
Jun-Liang Mao, The First People’s Hospital of Wenling, Wenling 317500, Zhejiang Province, China
Zheng-Chao Shi, Rui’an People’s Hospital, Rui’an 325200, Zhejiang Province, China
Wu-Heng Tang, Maternal and Child Health Hospital of Zhoushan City, Zhoushan 316000, Zhejiang Province, China
Xin-Jian Zhu, Shangyu People’s Hospital, Shaoxing 312300, Zhejiang Province, China
Wei Shao, People’s Hospital of Putuo District, Zhoushan 316399, Zhejiang Province, China
Xiao-Feng Zhang, Hangzhou First People’s Hospital, Hangzhou 310006, Zhejiang Province, China
Xing-Hua Wang, Qingtian People’s Hospital, Lishui 323900, Zhejiang Province, China
Yue-Feng Tong, The First People’s Hospital of Yongkang, Yongkang 321300, Zhejiang Province, China
Mi-Zu Jiang, The Children’s Hospital Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Guang-Lan Chen, Lishui People’s Hospital, Lishui 323000, Zhejiang Province, China
Zhi-Yong Wang, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China
Hui-Min Tu, Wuxi No. 4 Hospital Affiliated to Suzhou University, Wuxi 214062, Zhejiang Province, China
Guo-Fa Jiang, Jinhua Wenrong Hospital, Jinhua 321001, Zhejiang Province, China
Jian-Sheng Wu, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China
Xu-Peng Chen, Yueqing People’s Hospital, Wenzhou 325600, Zhejiang Province, China
Qiu-Long Ding, Tiantai People’s Hospital, Taizhou 317200, Zhejiang Province, China
Hong Ouyang, Lin’an people’s Hospital, Lin’an 311300, Zhejiang Province, China
Feng-Zhe Jin, Rui’an City TCM Hospital, Rui’an 325200, Zhejiang Province, China
Yan-Li Xu, Medical College of Hebei University of Engineering, Handan 056038, Hebei Province, China
Author contributions: Gong YN and Xu YL analyzed data and drafted this paper; Li YM and Yang NM were involved in designing the protocol and providing results of this study; Zhang JZ had the idea for this study and final responsibility for the decision to submit for publication; Li HZ, Guo F, Lin L, Wang QY, Zhang JK, Ji ZZ, Mao JB, Mao JL, Shi ZC, Tang WH, Zhu XJ, Shao W, Zhang XF, Wang XH, Tong YF, Jiang MZ, Chen GL, Wang ZY, Tu HM, Jiang GF, Wu JS, Chen XP, Ding QL, Ouyang H and Jin FZ were responsible for sample collection, the order of authorship was based on specific contribution; all authors were involved in data interpretation and critical revisions of the report, and approved the final version.
Supported by Grants from the Science and Technology Program of Zhejiang Province China, No. 2001C23140, National Technology RD Program in the 12th Five-Year Plan of China, No. 2012BAI06B02, the Major Technology Project as part of “Prevention and Control of Major Infectious Diseases including AIDS and Viral Hepatitis”, No. 2013ZX10004216-002, the National Key Scientific Instrument and Equipment Development Project, No. 2012YQ180117, the Medical and Health Science and Technology Plan Project of Zhejiang Province, No. 2012KYB248, and the Science and Technology Project of Zhejiang province, No. 2011C23140.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jian-Zhong Zhang, MD, PhD, State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, China. zhangjianzhong@icdc.cn
Telephone: +86-10-58900707 Fax: +86-10-58900700
Received: June 16, 2014
Peer-review started: June 16, 2014
First decision: July 21, 2014
Revised: August 11, 2014
Accepted: September 18, 2014
Article in press: September 19, 2014
Published online: January 21, 2015
Abstract

AIM: To evaluate the efficacy of centralized culture and possible influencing factors.

METHODS: From January 2010 to July 2012, 66452 patients with suspected Helicobacter pylori (H. pylori) infection from 26 hospitals in Zhejiang and Jiangsu Provinces in China underwent gastrointestinal endoscopy. Gastric mucosal biopsies were taken from the antrum for culture. These biopsies were transported under natural environmental temperature to the central laboratory in Hangzhou city and divided into three groups based on their transport time: 5, 24 and 48 h. The culture results were reported after 72 h and the positive culture rates were analyzed by a χ2 test. An additional 5736 biopsies from H. pylori-positive patients (5646 rapid urease test-positive and 90 14C-urease breath test-positive) were also cultured for quality control in the central laboratory setting.

RESULTS: The positive culture rate was 31.66% (21036/66452) for the patient samples and 71.72% (4114/5736) for the H. pylori-positive quality control specimens. In the 5 h transport group, the positive culture rate was 30.99% (3865/12471), and 32.84% (14960/45553) in the 24 h transport group. In contrast, the positive culture rate declined significantly in the 48 h transport group (26.25%; P < 0.001). During transportation, the average natural temperature increased from 4.67 to 29.14 °C, while the positive culture rate declined from 36.67% (1462/3987) to 24.12% (1799/7459). When the temperature exceeded 24 °C, the positive culture rate decreased significantly, especially in the 48 h transport group (23.17%).

CONCLUSION: Transportation of specimens within 24 h and below 24 °C is reasonable and acceptable for centralized culture of multicenter H. pylori samples.

Keywords: Centralized isolation, Helicobacter pylori, Influencing factor, Multiple centers, Personalized treatment

Core tip: This is the first large-scale study on the centralized culture of Helicobacter pylori in a large number of clinical samples from multiple centers. The efficacy of centralized culture and possible influencing factors were evaluated. The results confirm the feasibility of establishing a culture center for individualized medical use. The findings of this study can be promisingly applied in clinical and public health practice.