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Test ID: HELIS Helicobacter pylori Culture with Antimicrobial Susceptibilities, Varies

Useful For

Recovery of Helicobacter pylori from gastric specimens for antimicrobial susceptibility testing of the organism (amoxicillin, clarithromycin, levofloxacin, metronidazole and tetracycline are routinely tested)

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
GID Bacteria Identification No, (Bill Only) No
TISSR Tissue Processing No, (BIll Only) No
MIC Sensitivity, MIC No, (Bill Only) No
SUS Susceptibility No, (Bill Only) No
ISAE Aerobe Ident by Sequencing No, (Bill Only) No
HPCR1 H pylori + Clarithro Resistance PCR No, (Bill Only) No

Testing Algorithm

When this test is ordered, the reflex tests may be performed at an additional charged.

 

When Helicobacter pylori is isolated, identification will be confirmed and susceptibility testing performed. The routine susceptibility panel includes amoxicillin, clarithromycin, levofloxacin, metronidazole, and tetracycline.

 

In the event that an isolate of Helicobacter pylori does not grow for susceptibility testing, reflex testing for Helicobacter pylori with HPCR1 / Clarithromycin Resistance with Clarithromycin Resistance Prediction, Molecular Detection, PCR (Bill Only) may be added.

 

For test utilization options, see Helicobacter pylori Diagnostic Algorithm in Special Instructions.

Reporting Name

Helicobacter pylori Culture + Susc

Specimen Type

Varies


Shipping Instructions


Specimen must be received in laboratory within 48 hours of collection. Specimen should be collected and packaged as close to shipping time as possible.



Necessary Information


Specimen source is required; include the specific anatomic source.



Specimen Required


Preferred:

Specimen Type: Gastric biopsy

Container/Tube: Sterile container

Specimen Volume: Entire collection

Collection Instructions: Acquire biopsied tissue; moisten with sterile saline.

 

Acceptable:

Specimen Type: Gastric brushings or gastric aspirate

Container/Tube: Sterile container

Specimen Volume: Entire collection


Specimen Minimum Volume

0.5 mL or 0.5 × 0.2 × 0.2-cm sized piece of tissue

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Refrigerated 48 hours

Clinical Information

Helicobacter pylori is a spiral-shaped gram-negative bacterium that may cause chronic gastritis, peptic ulcer disease, or gastric neoplasia. In adults of industrialized countries, an estimated 0.5% of the susceptible population becomes infected each year, although the incidence has been decreasing over time. The organism may asymptomatically colonize humans. In suspected H pylori-associated disease, the noninvasive stool antigen or urea breath test is recommended. If patients fail to respond to treatment and antimicrobial resistance is suspected, gastric biopsy, gastric brushings, or gastric aspirate may be cultured to attempt to recover the organism for antimicrobial susceptibility testing to assess for resistance.

 

Multidrug regimens are required to attain successful cure of H pylori infection. Antimicrobial resistance in H pylori is increasing. Disease caused by H pylori resistant to clarithromycin is associated with a greater incidence of treatment failure than disease caused by a susceptible strain.

 

The Clinical and Laboratory Standards Institute (CLSI) recommends agar dilution for H pylori antimicrobial susceptibility testing. Amoxicillin, clarithromycin, levofloxacin, metronidazole and tetracycline are routinely tested. CLSI has defined interpretive categories for clarithromycin. The antimicrobials for which the European Committee on Antimicrobial Susceptibility Testing (EUCAST) defines interpretive categories include amoxicillin, clarithromycin, levofloxacin, metronidazole and tetracycline.

Reference Values

No growth after 7 days

Susceptibility results are reported as minimal inhibitory concentration (MIC) in mcg/mL and as susceptible, intermediate, or resistant according to breakpoint setting organizations, either the Clinical and Laboratory Standards Institute (CLSI) or the European Committee on Antimicrobial Susceptibility Testing (EUCAST), as applicable.

 

Susceptible:

A category defined by a breakpoint that implies that isolates with an MIC at or below or a zone diameter at or above the susceptible breakpoint are inhibited by the usually achievable concentrations of antimicrobial agent when the dosage recommended to treat the site of infection is used, resulting in likely clinical efficacy.

 

Intermediate:

A category defined by a breakpoint that includes isolates with MICs or zone diameters within the intermediate range that approach usually attainable blood and tissue levels and/or for which response rates may be lower than for susceptible isolates.

Note: The intermediate category implies clinical efficacy in body sites where the drugs are physiologically concentrated or when a higher than normal dosage of a drug can be used. This category also includes a buffer zone, which should prevent small, uncontrolled, technical factors from causing major discrepancies in interpretations, especially for drugs with narrow pharmacotoxicity margins.

 

Resistant:

A category defined by a breakpoint that implies that isolates with an MIC at or above the resistant breakpoint are not inhibited by the usually achievable concentrations of the agent with normal dosage schedules and/or that demonstrate MICs that fall in the range in which specific microbial resistance mechanisms are likely, and clinical efficacy of the agent against the isolate has not been reliably shown in treatment studies.(Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobial Susceptibility Testing. 30th ed. CLSI supplement M100. Clinical and Laboratory Standards Institute; 2020)

Interpretation

A positive result provides definitive evidence of the presence of Helicobacter pylori.

 

Organisms may be detected in asymptomatic (colonized) individuals.

 

False-negative culture results may occur since the organism may die between biopsy collection and laboratory culture.

Clinical Reference

Theel ES: Helicobacter pylori infection: Test utilization strategies for diagnosis. Mayo Medical Laboratories Communique 2013;38(6):1-8

Day(s) and Time(s) Performed

Monday through Sunday

Analytic Time

7 days

Test Classification

This test has been cleared, approved or is exempt by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

87081-Helicobacter pylori culture

87077-Bacteria identification (if appropriate)

87153-Aerobe Ident by Sequencing (if appropriate)

87176-Tissue processing (if appropriate)

87181-Susceptibility (if appropriate)

87186-Sensitivity, MIC (if appropriate)

87150-H pylori + Clarithro Resistance PCR (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HELIS Helicobacter pylori Culture + Susc 587-6

 

Result ID Test Result Name Result LOINC Value
HELIS Helicobacter pylori Culture + Susc 587-6

Method Name

Conventional Culture Techniques

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Microbiology Test Request (T244)

-Gastroenterology and Hepatology Client Test Request (T728)

Mayo Clinic Laboratories | Gastroenterology Catalog Additional Information:

mml-gi-id, mml-gi-intestinal-infections, mml-gi-intestinal-infections-hpylori