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Diagnosis of Helicobacter pylori infection may be established by invasive test. Culture of the organism is an invasive technique and is the most specific method.The test requiring endoscopic biopsy should be performed on the antrum and also at the upper to middle part of the gastric body. Culture can be considered as the reference method and is important if antimicrobial susceptibility testing is required. Sensitivity of the culture is variable and differs among laboratories because of the quality of the organism growth varies with the conditions used.When the culture is performed it is preferable to collect Helicobacter pylori isolates for future studies.Typing systems are used to discriminate between isolates of H. pylori for epidemiological and clinical purposes. Typeability is an important performance criteria of typing systems and the meta-analysis of studies confirmed that PCR- RFLP and RAPD analyses are excellent tecniques. A typeability could be obtained with Automates Ribotyping System when two enzymes, Hae III and Hind III for digestion DNA, are used. Microbiological isolation of Helicobacter pylori is important to determine the resistance status because the failure of therapy is often associated with secondary antibiotic resistance, retreatment should ideally be guided by data on susceptibility.
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