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Journal of Clinical Microbiology, March 2006, p. 976-980, Vol. 44, No. 3
0095-1137/06/$08.00+0     doi:10.1128/JCM.44.3.976-980.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Validation of String Test for Diagnosis of Helicobacter pylori Infections

Billie Velapatiño,² Jacqueline Balqui,² Robert H. Gilman,^1,2,3* Alejandro Bussalleu,¹ Willi Quino,¹ S. Alison Finger,^1,4 Livia Santivañez,² Phabiola Herrera,² Alejandro Piscoya,¹ Jose Valdivia,¹ Jaime Cok,¹ and Douglas E. Berg⁴

Universidad Peruana Cayetano Heredia, Lima, Perú,¹ Asociación Benéfica PRISMA, Lima, Perú,² Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,³ Departments of Molecular Microbiology, Genetics, and Medicine, Washington University Medical School, St. Louis, Missouri⁴

Received 20 August 2005/ Returned for modification 17 October 2005/ Accepted 8 December 2005

The method of recovering Helicobacter pylori DNA or viable cells absorbed on a string that a person has swallowed and that is retrieved an hour later (string test) should be a useful alternative to traditional analysis of cells or DNA obtained by endoscopy, which is invasive, uncomfortable, relatively costly, and ill-suited for community-based and pediatric studies. Here we assayed the sensitivity and validity of the string test versus conventional endoscopic biopsy for detecting and analyzing H. pylori infection. Forty-four people with gastric complaints were studied using both H. pylori culture and urease gene (ureB) PCR. H. pylori organisms cultured from strings and biopsy specimens from the same patients were fingerprinted by the randomly amplified polymorphic DNA (RAPD) method. Biopsy sections were also hematoxylin and eosin and silver stained for H. pylori detection. H. pylori was cultured from 80% of strings and detected by PCR from 91% of strings from participants whose biopsies had been H. pylori positive by culture, PCR, and/or histology. Strains recovered from strings and biopsy specimens yielded identical or closely related RAPD profiles in each of the 24 cases tested. We conclude that the string test is a useful method for H. pylori recovery and analysis when relatively noninvasive procedures are needed.

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* Corresponding author. Mailing address: The Johns Hopkins School of Public Health, Department of International Health, 615 N. Wolfe Street, Room W3501, Baltimore, MD 21205. Phone: (410) 955-6964. Fax: (410) 502-6733. E-mail: rgilman{at}jhsph.edu.

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Journal of Clinical Microbiology, March 2006, p. 976-980, Vol. 44, No. 3
0095-1137/06/$08.00+0     doi:10.1128/JCM.44.3.976-980.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

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