Helicobacter pylori: Overview and Considerations for Diagnostic Testing

Helicobacter pylori

August 2010

Helicobacter pylori is actually a very fascinating and unique organism. Helicobacter sp. inhabits the hepatobiliary and gastrointestinal tracts of birds and mammals, and survives within the mucous gel layer adjacent to the gastric epithelia in the cardia, corpus, and antrum of the human stomach.

As its name suggests, it is indeed a spirochete, assuming either a spiral, or a curved bacillary shape. It is approximately 0.3 to 1.0 micrometers wide by 1.5 to 10 micrometers long.

It will stain in a gram-negative fashion, and exhibit motility via bipolar flagella.

In the laboratory, Helicobacter survives best at 37 degrees centigrade, and at oxygen concentrations of 5% to 10%; thus it is microaerophilic. It is also hypercapnic, requiring carbon dioxide concentrations between 5% and 12%.

Useful to our identification schemes is the fact that it is oxidase positive, and exhibits a very strong urease activity.

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Jump to section:

• Introduction
• Overview
• Helicobacter pylori
• Helicobacter spp. History¹
• Epidemiology²
• Pathogenesis
• Diagnosis of Infection
• Testing
• Types of Testing
• Endoscopy
• Rapid Urease Test
• Culture
• Types of Testing
• Urea Breath Test
• Urea Breath Test Limitations
• Serology - IgM and IgA ELISA³
• Serology: IgG ELFA
• Serology
• Serology Limitations
• Fecal Antigen Test EIA
• "Test of Cure"
• Algorithm
• Conclusions
• Tests Available From Mayo Medical Laboratories
• References
• Questions?