Successful recovery of H. pylori from Rapid Urease Tests (CLO Tests)

OBJECTIVE: Culture of Helicobacter pylori (H. pylori) and the determination of its antibiotic susceptibility is of increasing importance with the rise in numbers of antibiotic-resistant strains. The aim of this study was to determine whether H. pylori could be successfully isolated from antral biopsies used in Rapid Urease Tests (CLOtests) in clinical practice. METHODS: Antral biopsies from patients undergoing endoscopy were inserted into the gel of CLOtests to determine the H. pylori status of the patients. If the CLOtest was positive at the end of the endoscopy session, it was kept at ambient temperature until processed. In the laboratory, biopsies were removed from the gel and cultured on selective and nonselective media. In an attempt to enhance the recovery rate of H. pylori, a subset of positive CLOtests were kept at 4°C from the time that the color change was noted until the removal of the biopsy. RESULTS: One hundred and forty-one positive CLOtests were studied at times between 1 h and 6 h postendoscopy. Culture success was 93% in the 1st hour but fell off sharply after 2 h (p < 0.001). Isolation was also improved if positive CLOtests were stored at 4°C and plated out within 4 h (p < 0.001). CONCLUSIONS: H. pylori can be successfully cultured from biopsies in CLOtests kept at room temperature within 2 h or within 4 h if kept at 4°C. Thus the antral biopsy in the CLOtest can be usefully retrieved when, in the light of the CLOtest result, the physician wishes to obtain both culture and antibiotic sensitivity results.