Are There Great Savings with Rapid Urease Test by One-Plus-One?

infection is found in more than 50% of humans, and the infection rate among adults in South Korea exceeds 60%. 1 For that reason, guidelines have been established for the management of H. pylori including the diagnostic method, determining who should be treated, and the recommended treatment. 2-4 In regions with low H. pylori prevalence , a test-and-treat strategy is usually recommend for those with dyspeptic symptoms but without so-called " alarm symptoms " such as weight loss, dysphagia, nausea, and vomiting. In that situation, noninvasive testing using the urea breath test (UBT), which shows high sensitivity (88% to 95%) and specificity (95% to 100%), is recommended along with a stool antigen test that shows similar diagnostic accuracy. 2 However, the " endoscope-and-treat " approach is recommended in regions with high prevalence of H. pylori and high incidence of gastric cancer such as in South Korea. When endos-copy is performed, a biopsy-based test, such as the rapid ur-ease test (RUT), histological evaluation, and H. pylori culture can be performed to confirm the current infection. The RUT is the most sensitive and specific of these tests (sensitivity, 85% to 97%; specificity, 92%). 4 The RUT is based on detecting activity of the urease enzyme , which breaks down urea to ammonia, increasing the pH of the medium. The CLOtest TM (Delta West Ltd., Bentley, Au-stralia) is the most frequently used commercially available RUT kit and provides results within 24 hours. Previous studies have evaluated the optimal site and number of gastric muco-sal biopsy specimens for more rapid and accurate diagnosis, 5,6 and found that the sensitivity of RUT could be improved by increasing the number of biopsy specimens and obtaining these specimens from the corpus greater curvature, where atro-phic changes rarely occur until the late stages of gastric atrophy. Another advantage of this strategy is that it reduces the time required for test results. Several ultra-rapid kits for RUT that have recently been made available have been reported to provide more sensitive results in a much shorter time, which enables their use in outpatient clinics. 7,8 In a paper published in Clinical Endoscopy, Moon et al. 9 compared the efficacy of RUT when tissues are evaluated separately versus when they are combined. The authors included 214 patients (with or without nonulcer dyspepsia symptoms) who underwent screening by esophagogastroduo-denoscopy. One test evaluated used two RUT kits to evaluate the antrum and body …