Diagnosis of H. pylori infection

Diagnostic methodSensitivity and specificityaTypical applicationRemarks
Invasive methods
    Histology>95%“Gold standard” in routine hospital diagnosticsRequires expert pathologist; also provides histological data on inflammation and atrophy
    Culture biopsy>95%Alternative gold standardAllows for testing of antimicrobial sensitivity; requires specific microbiological expertise
    Rapid urease (CLO) test>90%Cost-effective and rapid testRequires an additional test for confirmation of H. pylori infection
Noninvasive methods
    Urea breath test>95%Alternative gold standardVery useful, reliable test to evaluate success of eradication treatment of H. pylori; limited availability due to requirement of expensive equipment
    Fecal antigen test>90%Not widely used yetSimple test but may not be reliable for evaluation of success of eradication treatment of H. pylori
    Serology80-90%Mainly used for epidemiological studiesInsufficient reliability for routine screening; cannot prove ongoing infection due to immunological memory
  • a Global range, depending on regional variations and subjects.