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.

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

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.

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.

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.

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

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.