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HelpOrder Code HELIS Helicobacter pylori Culture with Antimicrobial Susceptibilities, Varies
Useful For
Recovery of Helicobacter pylori from gastric specimens for antimicrobial susceptibility testing of the organism (amoxicillin, clarithromycin, levofloxacin, metronidazole, rifampin, and tetracycline are routinely tested)
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| GID | Bacteria Identification | No, (Bill Only) | No |
| ISAE | Aerobe Ident by Sequencing | No, (Bill Only) | No |
| TISSR | Tissue Processing | No, (BIll Only) | No |
| MIC | Susceptibility, MIC | No, (Bill Only) | No |
| SUS | Susceptibility | No, (Bill Only) | No |
| HPCR1 | H pylori + Clarithro Resistance PCR | No, (Bill Only) | No |
Testing Algorithm
When this test is ordered, the reflex tests may be performed at an additional charge.
When Helicobacter pylori is isolated, identification will be confirmed, and susceptibility testing performed. The routine susceptibility panel includes amoxicillin, clarithromycin, levofloxacin, metronidazole, rifampin, and tetracycline.
If an isolate of H pylori does not grow for susceptibility testing, additional testing for H pylori with clarithromycin resistance prediction may be performed.
Reporting Name
Helicobacter pylori Culture + SuscSpecimen Type
VariesOrdering Guidance
For test utilization options, see Helicobacter pylori Diagnostic Algorithm.
Shipping Instructions
Specimen must be received in laboratory within 48 hours of collection. Specimen should be collected and packaged as close to shipping time as possible.
Necessary Information
Specimen source is required; include the specific anatomic source.
Specimen Required
Preferred:
Specimen Type: Fresh tissue or biopsy
Sources: Gastric
Container/Tube: Sterile container
Specimen Volume: 0.5 x 0.2 x 0.2-cm sized piece of tissue
Collection Instructions: Acquire biopsied tissue; moisten with sterile saline
Acceptable:
Specimen Type: Fluid
Sources: Gastric brushings, gastric aspirate
Container/Tube: Sterile container
Specimen Volume: Entire collection or 0.5 mL
Specimen Type: Fresh tissue or biopsy
Sources: Duodenum
Container/Tube: Sterile container
Specimen Volume: 0.5 x 0.2 x 0.2-cm sized piece of tissue
Collection Instructions: Acquire biopsied tissue; moisten with sterile saline
Specimen Minimum Volume
See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Refrigerated | 48 hours |
Reject Due To
| Biopsy submitted in fluid other than sterile saline | Reject |
Reference Values
No growth of Helicobacter pylori
Susceptibility results are reported as minimal inhibitory concentration (MIC) in mcg/mL. Breakpoints (also known as clinical breakpoints) are used to categorize an organism as susceptible, susceptible-dose dependent, intermediate, resistant, or nonsusceptible according to breakpoint setting organizations, either the Clinical and Laboratory Standards Institute (CLSI) or the European Committee on Antimicrobial Susceptibility Testing (EUCAST), as applicable.
In some instances, an interpretive category cannot be provided based on available data; therefore, the following comment will be included on the report: There are no established interpretive guidelines for agents reported without interpretations.
For information regarding CLSI and EUCAST susceptibility interpretations, see Susceptibility Interpretative Category Definitions.
Day(s) Performed
Monday through Sunday
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
87081-Helicobacter pylori culture
87077-Bacteria identification (if appropriate)
87153-Aerobe Ident by Sequencing (if appropriate)
87176-Tissue processing (if appropriate)
87181-Susceptibility per drug and per organism for drugs not in routine battery (if appropriate)
87186-Antimicrobial Susceptibility, Aerobic Bacteria, MIC-per organism for routine battery (if appropriate)
87150-H pylori + Clarithro Resistance PCR (if appropriate)
Method Description
The selective Helicobacter pylori media used for isolation has a Brucella agar base with added vancomycin, trimethoprim, polymyxin B, and vitamin K1. Fresh medium and high humidity are essential for organism recovery. Plates are incubated at 35° C in a microaerophilic atmosphere.(Couturier MR: Helicobacter. In: Carroll KC, Pfaller MA, eds. Manual of Clinical Microbiology. 12th ed. ASM Press; 2019:1044-1057)
The agar dilution method is used for susceptibility testing. The antimicrobial is added to agar in various concentrations depending upon levels attainable in serum. A standardized suspension of the organism is applied to the agar plates that are incubated for 72 hours at 35° C. Complete inhibition of all but 1 colony or a very fine residual haze represents the endpoint.(Clinical and Laboratory Standards Institute [CLSI]. Methods for Antimicrobial Dilution and Disk Susceptibility Testing of Infrequently Isolated or Fastidious Bacteria. 3rd ed. CLSI document M45.CLSI; 2015)
Special Instructions
Method Name
Conventional Culture Technique with Minimal Inhibitory Concentration (MIC) (Agar Dilution or Broth Microdilution or Gradient Diffusion) or Disk Diffusion if appropriate
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Microbiology Test Request (T244)