{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T10:35:59Z","timestamp":1774607759020,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T00:00:00Z","timestamp":1680825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Gastric mucosal swab may be a more sensitive sampling method than a biopsy since <jats:italic>Helicobacter pylori (H. pylori)<\/jats:italic> resides within the mucus layer. We compared the diagnostic performance of the rapid urease test (RUT) and bacterial load of <jats:italic>H. pylori<\/jats:italic> between swabs and tissue biopsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Overall, 276 RUTs (138 swab\u2010RUTs (S\u2010RUT) and 138 tissue\u2010RUTs (T\u2010RUT)) were performed. To diagnose <jats:italic>H. pylori<\/jats:italic> infection, RUT, <jats:italic>H. pylori<\/jats:italic> PCR, and 16S ribosomal RNA gene sequencing of tissue and swab were used, and its infection was defined as at least two positives of the six test results. The diagnostic performances of RUTs and the <jats:italic>H. pylori<\/jats:italic> bacterial load using qPCR were compared between swab and biopsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The positivity rates of S\u2010RUT and T\u2010RUT were 35.5% (49\/138) and 25.4% (35\/138), respectively. The sensitivity, specificity, and accuracy of S\u2010RUT were 98.0%, 100.0%, and 99.2%, while those of T\u2010RUT were 70.0%, 100%, and 89.1%, respectively. The sensitivity and accuracy were significantly higher for S\u2010RUT than for T\u2010RUT (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). In the patients with atrophic gastritis and intestinal metaplasia, S\u2010RUT showed significantly higher sensitivity than T\u2010RUT. qPCR showed that the swab contained a significantly higher <jats:italic>H. pylori<\/jats:italic> bacterial load than tissue biopsy (22.92\u2010fold and 31.61\u2010fold in the antrum and body (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Gastric mucosal swabs showed higher RUT accuracy and <jats:italic>H. pylori<\/jats:italic> bacterial load than a tissue biopsy. This may be an alternative to a biopsy when diagnosing <jats:italic>H. pylori<\/jats:italic> infection during endoscopy is necessary. (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>, NCT05349578).<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.12980","type":"journal-article","created":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T10:44:56Z","timestamp":1680864296000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Gastric mucosal swab as an alternative to biopsy for <i>Helicobacter pylori<\/i> detection"],"prefix":"10.1111","volume":"28","author":[{"given":"Hosim","family":"Soh","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology Seoul National University Hospital  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jangsup","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Neurology Seoul National University Hospital  Seoul South Korea"},{"name":"Department of Genomic Medicine Seoul National University Hospital  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han Myung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bokyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soo\u2010Jeong","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1799-9028","authenticated-orcid":false,"given":"Sang Gyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5159-357X","authenticated-orcid":false,"given":"Hyunsoo","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine  Seoul South Korea"},{"name":"Department of Medical Device Development Seoul National University Graduate School  Seoul South 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