Diagnostic Accuracy of Microbiological Culture for the Diagnosis of Helicobacter pylori Infection in Dyspeptic Patients taking Histopathological Examination as Gold Standard

Objective: To accurately estimate the efficacy of microbiological culture technique in the diagnosis of H. pylori infection. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital (PEMH), Rawalpindi, Pakistan, from Jan to Sep 2021. Methodology: Our study enrolled patients older than 18 years, who presented to PEMH during study period with history of chronic dyspepsia and underwent upper gastrointestinal endoscopy following which gastric tissue specimens were sent for histopathological and microbiological diagnosis. Cohen’s kappa coefficient (κ) was determined to estimate the statistical correlation between the two diagnostic measures. Results: A total of 73 patients having a chronic history of dyspepsia lasting approximately 7.0±4.0 months were studied. Mean patient age was 45.8±14.72 years, with 63% participants being males and 62% of participants had consumed Proton Pump Inhibitors (PPIs) for <12 weeks. A positive diagnosis for H. pylori infection was seen among patients with poor socioeconomic status and with a shorter duration of PPI therapy. Cohen’s coefficient revealed only a moderate level of agreement between histopathological diagnosis and microbiological culture technique (κ=0.60). Furthermore, microbiological diagnosis had a drastically lower sensitivity (66.7%) and specificity (92.6%) with diagnostic accuracy of 78.1 % as compared to its counterpart. Conclusion: Microbiological culture technique was found to have an inferior level of accuracy in the laboratory detection of H. pylori in contrast to histopathological diagnosis.