Practical rapid, minimally invasive, reliable nonendoscopic method to obtain Helicobacter pylori for culture

BACKGROUND: Helicobacter pylori culture typically requires endoscopy. AIM: To develop a minimally invasive rapid and reliable method to obtain H. pylori cultures. METHODS: An extendable oro-gastric brush, contained within a plastic over-tube, was constructed (Baylor Brush, US Endoscopy). After topical oral anesthesia, the 5-mm diameter brush assembly was swallowed. The brush was extended in the stomach and the mucosa was brushed three or four times. The brush was then retracted into the protective sleeve and withdrawn from the patient. The brush was either cultured directly or placed in cysteine transport medium with 20% glycerol which was then sampled immediately or after freezing at -70 degrees C. RESULTS: Twenty-five adult H. pylori-infected subjects (13 male, 12 female) were studied. Helicobacter pylori recovery rate was 100% (11 of 11) when cultured immediately or after storage in transport medium at -70 degrees C for 1 or 2 weeks or after storage at 4 degrees C for 24 hours (four of four) or 72 hours (four of four) before being cultured. Freezing on dry ice and air shipment did not reduce recovery. CONCLUSION: Rapid, reliable, nonendoscopic culture of gastric mucus is a practical method to obtain culture of H. pylori for clinical or research purposes. The method is amenable to being performed in a doctor's office or in the field.