Biopsies from the gastric mucosa (antrum, corpus) of 145 patients investigated by endoscopy were analysed for Campylobacter pylori. The results of bacteriological, histological, enzymatic and chemical methods were compared. Urease activity was determined both in biopsies (CLO-test) and in gastric secretion. Furthermore, the concentration of urea was measured in gastric secretion. 71% of gastritis, 86% of ulcus duodeni and 83% of ulcus ventriculi diagnosed by endoscopy produced positive histological and/or cultural results, while 100% of control persons exhibited negative for both parameters. The sensitivity of the CLO-test (n = 112) was 95% and its specificity 78% when compared with bacteriological and histological results. The majority of false positive results was due to delayed and incomplete reactions. However, when compared with endoscopic-histological results the specificity of the CLO-test was 100%. The results of a modification of CLO-test (without culture medium) were up to 5 hours comparable. There was no positive correlation between the concentration of urea in gastric secretion and the histological or cultural identification of Campylobacter pylori. However, the measurement of ammonia turned out to be promising (sensitivity 80%). None of the tests was sufficiently specific on its own, whereas a 100% specificity was achieved when both the CLO-test and the determination of ammonia in gastric secretion were performed.
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