Abstract

Background/Aims:
The influence of different media on the validity of the rapid urease test, including accuracy, reaction time and cost-effectiveness is evalu- ated.

Methodology:
Biopsies were obtained from the antral and body mucosa of 100 KMUH patients (51 men, 49 women; mean age: 54.0 years, range: 21-79 years old) undergoing gastroendoscopy due to dyspepsia. None of the patients had received any Helicobacter pylori eradicating treatment, nor any other antibiotic or bismuth treatment in the previous one month, nor had they had any type of gastric operation in the past. Helicobacter pylori status was evaluated by seven different tests: culture, histology,

home-made rapid urease test, 13C-urea breath test, and three different commercially available rapid urease tests - including the CLOtest, the Pronto Dry test, and the Pyloriset Urease test. Helicobacter pylori status was denned as positive when the culture was positive or if concordance of two of the other three tests (histology, homemade rapid urease test and 13C-urea breath test) was positive.

Results:
Three different rapid urease tests have similar sensitivities (97.3% us. 100% vs. 100%) and specificities (98.4% us. 96.8% us. 98.2%), and accuracy (98.4% us. 96.8% us. 98.2%). But the reaction time was longer in the CLOtest than for the other two rapid urease tests (22.3 us. 5.6 us. 10.1 minutes) (P < 0.05).

The Pronto Dry test and the Pyloriset Urease test also have more rapid positive rate than CLOtest. However, in vitro study, three tests show similar rapidity of positive reaction at different densities of Helicobacter pylori.

Conclusions:
These three tests have practical advantages for physicians who need a rapid and accurate method of diagnosing Helicobacter pylori infections. The Pronto Dry test and Pyloriset Urease test have degrees of accuracy similar to the CLOtest, but results are obtained more rapidly and they are cheaper. Furthermore, the Pronto Dry test can be stored at room temperature and thereby save on the storage expense.

Conclusion:
Pronto Dry® is significantly more accurate than CLOtest® i detecting Helicobacter pylori infection at any time interval from 15 minutes to 25 Hours.
Pronto Dry ® is best evaluated at 24 hour interval when the highest accuracy is obtained.