Basic Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2015; 21(9): 2622-2628
Published online Mar 7, 2015. doi: 10.3748/wjg.v21.i9.2622
Isolation and diagnosis of Helicobacter pylori by a new method: Microcapillary culture
Adil M Allahverdiyev, Melahat Bagirova, Reyhan Caliskan, Hrisi Bahar Tokman, Hayat Aliyeva, Gokce Unal, Olga Nehir Oztel, Emrah Sefik Abamor, Hilal Toptas, Pelin Yuksel, Fatma Kalayci, Mustafa Aslan, Yusuf Erzin, Kadir Bal, Bekir S Kocazeybek
Adil M Allahverdiyev, Melahat Bagirova, Gokce Unal, Olga Nehir Oztel, Emrah Sefik Abamor, Hilal Toptas, Department of Bioengineering, Yildiz Technical University, 34201 Istanbul, Turkey
Reyhan Caliskan, Hrisi Bahar Tokman, Pelin Yuksel, Fatma Kalayci, Mustafa Aslan, Bekir S Kocazeybek, Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, 34098 Istanbul, Turkey
Hayat Aliyeva, Department of Microbiology and Immunology, Azerbaijan Medical University, AZ1022 Baku, Azerbaijan
Yusuf Erzin, Kadir Bal, Department of Gastroenterology, Cerrahpasa Faculty of Medicine, Istanbul University, 34098 Istanbul, Turkey
Author contributions: Allahverdiyev AM designed and drafted the research; Tokman HB and Kocazeybek BS contributed to design of the research, assisted in the scientific writing of the paper; Erzin Y and Bal K provided the biopsy samples; Caliskan R, Aliyeva H, Unal G, Oztel ON, Abamor ES, Toptas H and Kalayci F performed all the microbiological procedures; Bagirova M, Yuksel P and Aslan M interpreted the results and reviewed the literature.
Supported by Yildiz Technical University Scientific Research Projects Coordinatorship, No. 2012-07-04-KAP09.
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: Adil M Allahverdiyev, Professor, Department of Bioengineering, Yildiz Technical University, Yildiz Mh, 34201 Istanbul, Turkey. adilmoglu@gmail.com
Telephone: +90-212-3834639 Fax: +90-212-3834625
Received: April 14, 2014
Peer-review started: April 14, 2014
First decision: June 10, 2014
Revised: July 26, 2014
Accepted: November 8, 2014
Article in press: November 11, 2014
Published online: March 7, 2015
Processing time: 329 Days and 11.1 Hours
Abstract

AIM: To investigate the performance of the microcapillary culture method (MCM) in Helicobacter pylori (H. pylori) isolation and diagnosis.

METHODS: Microcapillary culture (MC), classical culture (CC), rapid urease (CLO) test, and histopathologic examination (HE) were performed with biopsy samples. Homogenized biopsy samples were loaded into capillary tubes and incubated for 48 h at 37 °C without providing a microaerophilic environment. Additionally, three or four loops of the homogenized sample were inoculated in a ready-to-use selective medium (Becton Dickinson, Helicobacter Agar, Modified) specific for the isolation of H. pylori and incubated at 37 °C in a microaerophilic atmosphere provided by CampyGen (Becton Dickinson, GasPack). Bacteria reproducing in microcapillary tubes were evaluated in an inverted microscope and also were evaluated after performing a CC with the content. Results obtained by CC, CLO test, and HE were compared with those of MC. The diagnostic performances of the methods used in this study were evaluated for specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and CI.

RESULTS: H. pylori was found positive by CLO test + HE and/or CC culture in 26 patient antrum and corpus biopsy samples. In 25 (25/26) patient biopsy samples, H. pylori was isolated by MCM, whereas in only 14 (14/26) patient biopsy samples, H. pylori was isolated by CC. CLO test and HE were found positive in 17 (17/26) patient biopsy samples. Comparing the results of the isolation of H. pylori by MCM, CC, CLO test, and HE, the sensitivity of the MCM was found as 96%, the specificity as 80%, the PPV as 83%, the NPV as 95%, and the 95%CI as 0.76 (χ2 = 31.51, P < 0.01) whereas the sensitivity of the CC was found as 54% (χ2 = 19.15, P < 0.01), and the sensitivity of the CLO test and HE were found as 65% (χ2 = 25.26, P < 0.01).

CONCLUSION: This new microcapillary cultivation method for H. pylori has high diagnostic sensitivity compared with CC, HE, and CLO tests.

Keywords: Microcapillary culture; Classical culture; New method; Isolation of Helicobacter pylori; Comparison

Core tip: Nowadays, isolation of Helicobacter pylori (H. pylori) from gastric tissues by using classical culture is accepted as the gold standard, according to Maastricht criteria. Additionally, surveillance of increased or decreased minimal inhibitory concentration values of antimicrobial substances, according to applied treatment policy and geographical regions, may only be possible with the cultivation of bacteria. On the other hand, the diagnostic sensitivity of classical culture is low due to problems in standardization of the medium in order to provide microaerophylic conditions. In this study, for the first time, we report the high diagnostic sensitivity of the microcapillary culture method for diagnosis of H. pylori.