一种新方法——微毛细管培养法对幽门螺杆菌的分离与诊断
Isolation and diagnosis of Helicobacter pylori by a new method: microcapillary culture.
作者信息
Allahverdiyev Adil M, Bagirova Melahat, Caliskan Reyhan, Tokman Hrisi Bahar, Aliyeva Hayat, Unal Gokce, Oztel Olga Nehir, Abamor Emrah Sefik, Toptas Hilal, Yuksel Pelin, Kalayci Fatma, Aslan Mustafa, Erzin Yusuf, Bal Kadir, Kocazeybek Bekir S
机构信息
Adil M Allahverdiyev, Melahat Bagirova, Gokce Unal, Olga Nehir Oztel, Emrah Sefik Abamor, Hilal Toptas, Department of Bioengineering, Yildiz Technical University, 34201 Istanbul, Turkey.
出版信息
World J Gastroenterol. 2015 Mar 7;21(9):2622-8. doi: 10.3748/wjg.v21.i9.2622.
AIM
To investigate the performance of the microcapillary culture method (MCM) in Helicobacter pylori (H. pylori) isolation and diagnosis.
METHODS
Microcapillary culture (MC), classical culture (CC), rapid urease (CLO) test, and histopathologic examination (HE) were performed with biopsy samples. Homogenized biopsy samples were loaded into capillary tubes and incubated for 48 h at 37 °C without providing a microaerophilic environment. Additionally, three or four loops of the homogenized sample were inoculated in a ready-to-use selective medium (Becton Dickinson, Helicobacter Agar, Modified) specific for the isolation of H. pylori and incubated at 37 °C in a microaerophilic atmosphere provided by CampyGen (Becton Dickinson, GasPack). Bacteria reproducing in microcapillary tubes were evaluated in an inverted microscope and also were evaluated after performing a CC with the content. Results obtained by CC, CLO test, and HE were compared with those of MC. The diagnostic performances of the methods used in this study were evaluated for specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and CI.
RESULTS
H. pylori was found positive by CLO test + HE and/or CC culture in 26 patient antrum and corpus biopsy samples. In 25 (25/26) patient biopsy samples, H. pylori was isolated by MCM, whereas in only 14 (14/26) patient biopsy samples, H. pylori was isolated by CC. CLO test and HE were found positive in 17 (17/26) patient biopsy samples. Comparing the results of the isolation of H. pylori by MCM, CC, CLO test, and HE, the sensitivity of the MCM was found as 96%, the specificity as 80%, the PPV as 83%, the NPV as 95%, and the 95%CI as 0.76 (χ (2) = 31.51, P < 0.01) whereas the sensitivity of the CC was found as 54% (χ (2) = 19.15, P < 0.01), and the sensitivity of the CLO test and HE were found as 65% (χ (2) = 25.26, P < 0.01).
CONCLUSION
This new microcapillary cultivation method for H. pylori has high diagnostic sensitivity compared with CC, HE, and CLO tests.
目的
研究微量毛细管培养法（MCM）在幽门螺杆菌（H. pylori）分离及诊断中的性能。
方法
对活检样本进行微量毛细管培养（MC）、经典培养（CC）、快速尿素酶（CLO）试验及组织病理学检查（HE）。将匀浆后的活检样本装入毛细管，在不提供微需氧环境的条件下于37 °C孵育48小时。此外，将匀浆样本的三到四环接种于用于分离幽门螺杆菌的即用型选择性培养基（Becton Dickinson，改良幽门螺杆菌琼脂）中，并在由CampyGen（Becton Dickinson，气体发生袋）提供的微需氧环境中于37 °C孵育。在倒置显微镜下评估在微量毛细管中繁殖的细菌，并在用其中的内容物进行经典培养后也进行评估。将经典培养、CLO试验和HE获得的结果与微量毛细管培养的结果进行比较。对本研究中使用的方法的诊断性能进行特异性、敏感性、阳性预测值（PPV）、阴性预测值（NPV）和可信区间（CI）的评估。
结果
在26例患者的胃窦和胃体活检样本中，通过CLO试验+HE和/或经典培养发现幽门螺杆菌呈阳性。在25（25/26）例患者活检样本中，通过微量毛细管培养法分离出幽门螺杆菌，而在仅14（14/26）例患者活检样本中，通过经典培养分离出幽门螺杆菌。在17（17/26）例患者活检样本中CLO试验和HE呈阳性。比较微量毛细管培养法、经典培养、CLO试验和HE分离幽门螺杆菌的结果，发现微量毛细管培养法的敏感性为96%，特异性为80%，阳性预测值为83%，阴性预测值为95%，95%可信区间为0.76（χ(2)=31.51，P< 0.01），而经典培养的敏感性为54%（χ(2)=19.15，P< 0.01），CLO试验和HE的敏感性为65%（χ(2)=25.26，P< 0.01）。
结论
这种用于幽门螺杆菌的新型微量毛细管培养法与经典培养、组织病理学检查和CLO试验相比具有较高的诊断敏感性。
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