H. Pylori Urease, Tissue

1. Obtain media from Microbiology.
2. A small piece of tissue is collected during endoscopy procedure.
3. Place tissue directly into the Rapid Urea Medium.  Submerge the tissue specimen in the Rapid Urea Medium using a sterile applicator stick or cotton swab. For faster results, incubate at 35+2^oC. Room temperature incubation will not harm the test but may exhibit a slower reaction, often up to 24 hours.
4. Label the reagent vial with appropriate patient information.
   • For specimens collected at the hospital Endoscopy departments, order the test in the hospital’s computer system, and label specimen appropriately.
   • For patient specimens collected outside of the hospital facilities, complete a laboratory requisition.  In the Miscellaneous section, order as “H.pylori, tissue”.
5. Send Rapid Urea Medium vial containing specimen immediately to the laboratory.
6. Microbiology will incubate at 35+2^oC for up to 24 hours. Note:  Positive reactions can often occur within minutes.  If result is positive before you send it to the lab, please send to lab anyway so a patient result report can be generated.

This Rapid Urea Medium is used for the rapid determination of urease activity in bacteria such as Helicobacter pylori. Organisms that possess the urease enzyme can split urea into ammonium carbonate and ammonia which are alkaline in nature. This method which measures the shift in pH, has been used to help simplify the diagnosis of H.pylori, especially those specimens originating from duodenal and gastric ulcers and chronic antral gastritis (type B).

Because urease is not produced by mammalian cells, any enzyme activity detected in the gastric mucosa is of bacterial origin. Since H.pylori is the only organism that can survive in the stomach in significant numbers, the specimen is not likely to be contaminated with other bacteria.