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J Med Microbiol 57 (2008), 814-819; DOI: 10.1099/jmm.0.47768-0
© 2008 Society for General Microbiology
ISSN 1473-5644

Urease-positive bacteria in the stomach induce a false-positive reaction in a urea breath test for diagnosis of Helicobacter pylori infection

Takako Osaki1, Katsuhiro Mabe2, Tomoko Hanawa1 and Shigeru Kamiya1

1 Department of Infectious Diseases, Kyorin University School of Medicine, Mitaka, Tokyo, Japan

2 Department of Internal Medicine, Yamagata Prefectural Central Hospital, Yamagata, Japan

Correspondence
Shigeru Kamiya
skamiya{at}kyorin-u.ac.jp

Received 16 November 2007
Accepted 7 February 2008

This study investigated the influence of urease-positive non-Helicobacter pylori bacteria on the results of a urea breath test (UBT) to evaluate the diagnostic utility of a UBT using film-coated [13C]urea tablets. The UBT was performed in 102 patients treated with a proton pump inhibitor and antibiotics for the eradication of H. pylori. Urease-producing bacteria other than H. pylori were isolated and identified from the oral cavity and stomach. In 4/102 patients, the UBT gave false-positive results. These false-positive results were found to be caused by the presence of urease-positive bacteria in the oral cavity and stomach. Five bacterial species with urease activity (Proteus mirabilis, Citrobacter freundii, Klebsiella pneumoniae, Enterobacter cloacae and Staphylococcus aureus) were subsequently isolated from the oral cavity and/or stomach. As there was no correlation between the in vitro urease activity of urease-positive non-H. pylori bacteria and the UBT value, and all of the patients with a false-positive UBT result were suffering from atrophic gastritis, it is possible that the false-positive results in the UBT were a result of colonization of urease-positive bacteria and gastric hypochlorhydric conditions. Thus, for the diagnosis of H. pylori infection using a UBT, the influence of stomach bacteria must be considered when interpreting the results.

Abbreviations: RUT, rapid urease test; UBT, urea breath test.






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