Objective: To evaluate the reliability of the different available diagnostic tests like culture (microscopy) and PCR and to compare and understand the accuracy of these diagnostic tests for H. pylori detection in gastric biopsies samples. Design: Experimental. Methodology: Biopsy specimens was collected from a total of 78 suspected patients with gastrointestinal complications and who visited endoscopy section of Hayatabad Medical Complex Peshawar. The gastric biopsy samples were cultured and then subjected to microscopy and various biochemical assays. Genomic DNA was extracted from urease positive samples and PCR was performed for the amplification of  species specific 16SrRNA gene of H. pylori. Kappa coefficient and McNemar’s test was applied for the evaluation of the agreement between the results of both assays.  Result: Infection with H. pylori was confirmed by both assays i.e., culture (microscopy) and PCR in 10 (13%) infected individuals. In a total of 10 infected individuals, 10 patients were confirmed by PCR and 3 patients by culture (microscopy). The agreement between two test results was 70.5% and disagreed by 29.5% considering the p value > 0.05 as significant.  Conclusion: PCR assay was found to be more sensitive than culture (microscopy) for the detection of H. pylori infection. However, due to unavailability of the gold standard assay for H. pylori detection,  combination of both assays were recommended to boost the diagnostic accuracy.

Index Terms- H. pylori; Culture; PCR; Endoscopy; Biopsy