Basic Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Jan 22, 2022; 13(1): 34-40
Published online Jan 22, 2022. doi: 10.4291/wjgp.v13.i1.34
Combined antrum and corpus biopsy protocol improves Helicobacter pylori culture success
Denise E Brennan, Colm O'Morain, Deirdre McNamara, Sinead M Smith
Denise E Brennan, Colm O'Morain, Deirdre McNamara, Sinead M Smith, Department of Clinical Medicine, Trinity College Dublin, Trinity Centre, Tallaght University Hospital, Dublin D24, Ireland
Author contributions: McNamara D conceived the study; Brennan DE and Smith SM performed experiments, acquired and analysed data; O’Morain C and McNamara D recruited patients and collected samples; Smith SM prepared the manuscript; all authors critically reviewed the manuscript and approved the final version; Smith SM and McNamara D contributed equally.
Supported by Health Research Board, No. HRA-POR-2014-526, and No. APA-2019-030.
Institutional review board statement: The study was reviewed and approved by the Joint Research Ethics Committee of St. James’s Hospital and Tallaght University Hospital.
Conflict-of-interest statement: All authors have nothing to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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:
Corresponding author: Sinead M Smith, BSc, PhD, Assistant Professor, Department of Clinical Medicine, Trinity College Dublin, Trinity Centre, Tallaght University Hospital, Tallaght, Dublin D24, Ireland.
Received: July 23, 2021
Peer-review started: July 23, 2021
First decision: October 3, 2021
Revised: October 16, 2021
Accepted: January 14, 2022
Article in press: January 14, 2022
Published online: January 22, 2022
Research background

Helicobacter pylori (H. pylori) represents a public health issue as the causative agent of chronic gastritis, peptic ulcer disease, gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma. Success rates for current therapies have fallen over the years, mainly due to antimicrobial resistance. International guidelines recommend that treatment choices are based on local antimicrobial resistance rates. However, H. pylori culture is challenging and culture-based antimicrobial susceptibility testing (AST) is not routinely performed in most healthcare facilities.

Research motivation

Optimisation of H. pylori culture from clinical specimens will enable more widespread AST for H. pylori.

Research objectives

This research aimed to evaluate biopsy sampling protocols to enhance H. pylori culture success, specifically to determine whether dual antrum and corpus biopsy sampling was superior to a single antrum biopsy sampling protocol.

Research methods

Stomach tissue biopsies from rapid-urease test positive patients were collected in tubes containing Dent’s transport medium. Biopsies were used to inoculate Colombia blood agar plates. Plates were incubated under microaerobic conditions and evaluated for the presence of H. pylori. Culture success rates when a single antrum biopsy was used were compared to those when dual antrum and corpus biopsies were used.

Research results

H. pylori was successfully cultured in a significantly higher number of cases when combined antrum and corpus biopsies were used compared to a single antrum biopsy sample.

Research conclusions

A combined corpus and antrum biopsy sampling approach improves H. pylori culture success compared to a single antrum biopsy sampling protocol.

Research perspectives

Optimisation of H. pylori culture methods will encourage more widespread AST. Antimicrobial resistance surveillance is the key to determining the most appropriate antimicrobials for H. pylori eradication.