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"Latar Belakang: Eradikasi Helicobacter pylori menggunakan antimikrobaklaritromisin, amoksisilin yang dikombinasi PPI selama 10-14 hari. Resistensiantimikroba menjadi penyebab utama kegagalan terapi. Amoksisilin sebagai salah satu rejimen terapi lini pertama H.pylori telah dilaporkan resistensi sebesar 5,2% di Indonesia tahun 2016. Beberapa penelitian menunjukkan multiple point mutation gen pbp1 hanya ditemukan pada strain H.pylori resisten amoksisilin. Kesulitan melakukan biakan Helicobacter pylori menyebabkan uji biologi molekuler sebagai pilihan alternatif.Tujuan : Penelitian ini ditujukan untuk mengembangkan uji deteksi resistensi H.pylori dengan gen penyandi pbp 1.Metode : Penelitian ini merupakan studi retrospektif 2017-2019. Sampel H.pyloripositif histopatologis dari Departemen PA dikumpulkan sebanyak 54 sampel blokparafin dari pasien RSUPN Dr. Cipto Mangunkusumo antara tahun 2017-2019 ,dilakukan uji Real Time PCR. Hasil positif Real Time PCR dilanjutkan uji nested PCR untuk mencari gen pbp 1 dan dilakukan sekuensing Hasil : Dari 34 sampel positif Real Time PCR didapatkan lima positif gen pbp 1, tetapihanya empat gen pbp 1 yang dapat dianalisis setelah sekuensing. Hasil analisis dijumpai lima sekuen (sekuen 21, 1, 27, 32A, 32B), ditemukan juga tiga titik mutasi asam amino (Lys648Gln, Arg649Lys, Arg656Pro) yang berdasarkan penelitian sebelumnya hanya ditemukan pada strain H.pylori resisten amoksisilin. Empat sampel yang positif yaitu pada pasien tumor antrum lambung susp keganasan, ulkus gaster, gastritis kronis dan riwayat infeksi H.pylori dalam keluarga.Kesimpulan : Uji biologi molekuler menggunakan gen pbp 1 sebagai gen penyandiresisten amoksisilin dapat digunakan sebagai uji alternatif untuk mendeteksi resistensi amoksisilin pada penderita infeksi H.pylori. Hasil analisis mutasi asam amino pada uji penelitian ini menunjukkan terdapatnya multiple point mutation yang sesuai dengan strain H.pylori resisten amoksisilin di Korea.

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Background: To eradicate Helicobacter pylori infection, physician administered clarithromycin and amoxicillin plus proton pump inhibitor during 10-14 days.

Antimicrobial resistance is known as the major cause of treatment failure. The

prevalence of Helicobacter pylori resistant strains against Amoxicillin in Indonesia was5,2% in 2016. Several studies in amoxicillin-resistant H.pylori strains had shown multiple point mutation in the pbp1 gene. Molecular method as an alternative tool was chosen due to the difficulties in cultivate H.pylori in a synthetic media.

Aim: This research was aimed to develop H.pylori resistance detection tests using pbp 1 gene.

Methods: The study was a retrospective study, with 54 histopathology of H.pylori

positive samples obtained from patients at RSUPN dr. Cipto Mangunkusumo between

2017 to 2019. Real-time PCR tests were used to screen the samples before proceeded to nested PCR and obtained the pbp1 gene for sequencing.

Results: After the initial real-time PCR, 34 H.pylori positive samples were included in the study. From 34 samples of paraffin block only five specimens with positive pbp 1 genes, but only four samples can be analyzed after sequencing. The results found five sequences (sequences 21, 1, 27, 32A dan 32B), also found three amino acid mutation points (Lys648Gln, Arg649Lys, Arg656Pro) which were found only in amoxicillinresistant H.pylori strains. The four samples were collected from patients with antrum gastric tumor suspected as malignancy, gastric ulcer, chronic gastritis, and family history of H. pylori infection.

Conclusion: Molecular approach to detect pbp 1 gene encoding for amoxicillin

resistance could be used as an alternative of antibiotic susceptibility test. The multiple point mutations found in this reseach were in accordance with the amoxicillin-resistant H.pylori strains in Korea."

"Latar belakang : Asosiasi Gastroenterologi Indonesia melaporkan bahwa infeksi H. pylori di Indonesia telah mencapai 22,1% dari pasien dengan gejala dispepsia. Salah satu masalah dalam pengobatan infeksi H.pylori yaitu terdapatnya resistensi H.pylori terhadap antibiotik. Metronidazol telah dilaporkan menunjukkan resistensi terbesar 46,7% di Indonesia, dan sampai saat ini metronidazol masih digunakan sebagai terapi lini pertama. Peneliti sebelumnya telah melaporkan bahwa terdapatnya mutasi gen rdxA H. pylori dapat digunakan sebagai penanda resistensi metronidazol. Bentuk kokoid dari H. pylori sulit dideteksi oleh biakan. Alternatif uji lain yaitu menggunakan uji biologi molekuler yaitu deteksi mutasi menggunakan uji PCR diikuti dengan sekuensing DNA. Tujuan : Penelitian ini diharapkan dapat memberikan informasi baru tentang pengembangan uji resistensi H. pylori, menambah literatur sekuens unik gen rdxA H.pylori dan untuk menentukan mutasi gen rdxA H. pylori yang diprediksi berperan dalam resistensi H. pylori terhadap metronidazol. Metode : Penelitian ini bersifat eksploratif menggunakan 34 sampel blok parafin biopsi lambung yang telah dikonfirmasi mengandung DNA H.pylori pada uji real time PCR. Penelitian ini menggunakan uji nested PCR dan diikuti uji sekuensing DNA, kemudian dilanjutkan analisis bioinformatika yang terdiri dari analisis perubahan asam amino, homologi, filogenetik, konformasi protein dan penambatan molekuler (docking). Hasil : Berdasarkan hasil penelitian, dijumpai terdapatnya mutasi pada gen rdxA akibat insersi dua asam amino, substitusi, frameshift, dan ditemukan premature stop codon. Hasil analisis docking menunjukkan bahwa senyawa metronidazol kurang efektif terhadap H.pylori yang memiliki mutasi insersi dua asam amino, sedangkan H.pylori yang memiliki mutasi substitusi (tanpa insersi) menunjukkan afinitas yang lemah antara metronidazol dan gen rdxA H.pylori. Kesimpulan : Metode molekuler dapat menjadi uji alternatif untuk menguji resistensi H. pylori terhadap antibiotik. Telah ditemukannya sekuens unik berupa insersi dua asam amino yang belum ditemukan pada literatur lain, dapat menambah ilmu pengetahuan bagi para ilmuwan dibidang sains kedokteran. Keberadaan gen rdxA H.pylori yang bermutasi telah dibuktikan dapat menyebabkan resistensi terhadap metronidazol melalui analisa docking.

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Background : The Indonesian Gastroenterology Association reports that H. pylori infections has reached 22.1% of patients with dyspeptic symptoms in Indonesia. One of the problems in the prevention and treatment of H. pylori infection is H. pylori resistance to some antibiotics as first-line therapy. Metronidazole has been reported to show the greatest resistance of 46.7% in Indonesia, and to date metronidazole is still used as first-line therapy. The presence of rdxA gene mutations in H. pylori isolates can be used as a marker of metronidazole resistance. The cocoid form of H. pylori is difficult to detect by culture. Another alternative test is to use molecular biology tests, namely the detection of mutations using the PCR test followed by DNA sequencing. Aim : This research is expected to provide new information about the development of H. pylori resistance tests, add to the unique sequences H.pylori rdxA gene literatur and to determine the H. pylori rdxA gene mutation plays a role in H. pylori resistance to metronidazole. Methods : This explorative study used 34 samples of gastric biopsy paraffin blocks that were confirmed that were confirmed to contain H. pylori DNA Indonesian strain in a real time PCR test. The sample was analyzed using a nested PCR test and followed by DNA sequencing test, and bioinformatics analysis consisting of amino acid changes, homology, phylogenetics, protein conformation and molecular docking. Result : In this study, the results showed that mutations were found in the rdxA gene sequence due to the insertion of two amino acids, substitution, frameshift, and found premature stop codon. The results of the docking analysis showed that the metronidazole compound was less effective against H. pylori which had insertion of two amino acids, whereas H. pylori which had substitution (without insertion) showed a weak affinity between metronidazole and the rdxA gene. Conclusion : Molecular method can be an alternative to test H. pylori resistance to antibiotics. The discovery of a unique sequence in the form of the insertion of two amino acids that have not been found in other literature, can increase knowledge for scientists in the field of medical science. The presence of the mutated H. pylori rdxA gene has been shown to cause resistance to metronidazole through docking analysis. "

"Latar belakang: Dispepsia merupakan gangguan kesehatan yang sering ditemuierologi dan urin (RAPIRUN) dibandingkan dengan UBT sebagai baku emas dalam mengetahui infeksi H. pylori. Penelitian dilakukan pada pasien rawat jalan Puskesmas Kecamatan Koja Kotamadya Jakarta Utara. Yang dinilai adalah sensitivitas, spesivisitas, positive predictive value (PPV), negative predictive value (NPV) tes tersebut. Tujuan: Mengetahui akurasi diagnostik pemeriksaan non-invasif (serologi dan urin) dibandingkan dengan UBT (urea breath test) sebagai baku emas untuk mendeteksi infeksi H. pylori pada pasien dengan sindroma dispepsia. Metode: Penelitian yang digunakan adalah studi potong lintang untuk mengetahui akurasi pemeriksaan non-invasif yaitu s H. pylori menunjukkan hasil positif pada 36,5% subyek, sedangkan pada pemeriksaan serologi (Mataram, Biomedika) didapatkan hasil positif sebanyak 32,4%. Pemeriksaan RAPIRUN (Rapid Urine Test, Otsuka) menunjukkan hasil positif pada 24,3% subyek. Pada serologi didapatkan sensitivitas 74%, spesifitas 91%, PPV 83%, NPV 86%. Sedangkan pada RAPIRUN didapatkan sensitivitas 63%, spesifitas 98%, PPV 94%, NPV 82%. Hasil: Selama kurun waktu April 2015 sampai Juni 2015, 74 subyek, dengan mayoritas perempuan (82,4%), dengan rerata umur 45,05 tahun menjalani pemeriksaan non-invasif. Pemeriksaan UBT sebagai baku emas diagnosis infeksi di pelayanan kesehatan. Infeksi Helicobacter pylori adalah salah satu penyebab dispepsia. Diagnosis infeksi H.pylori dapat dilakukan melalui pemeriksaan invasif dan non invasif. Pemeriksaan non invasif lebih mampu laksana, murah dan memiliki risiko yang lebih sedikit. Simpulan: RAPIRUN lebih unggul dalam hal spesifisitas dibanding serologi.

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Background: Dyspepsia is the common problem in the population. The main etiology of dyspepsia is Helicobacter pylori infection. The diagnosis of H. pylori infection is based on invasive examination and non-invasive examination. The non-invasive examination could be easier to do and have less risk than invasive examination.

Objective: To evaluate the diagnostic accuracy of the non-invasive test (serology and RAPIRUN) compared to UBT as gold standard examination to detect H. pylori infection in patients with dyspepsia syndrome.

Methods: A cross-sectional study for diagnostic H. pylori by using serology and Rapid Urine test (RAPIRUN) is conducted to evaluate the diagnostic accuracy of non-invasive test compared to UBT as gold standard examination in patients with dyspepsia syndrome. This study was conducted at outpatient Community Health Center in Koja District North Jakarta from middle April 2015 until Middle June 2015. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were used to evaluate the diagnostic accuracy.

Results: From mid-April 2015 to Mid-June 2015, 74 subjects, with the majority of patients was female (82.4%), and the mean of age was 45.05 years old, had undergone non-invasive test The UBT test as the gold standard examination for H. pylori infection showed positive result in 36.5% patients while the serology test resulting positive in 32.4%. The RAPIRUN test resulting positive in 32.4% patients. The sensitivity of serology test was 74%, specificity 91%, PPV 83%, NPV 86%, meanwhile the RAPIRUN test was resulting as sensitivity 63%, specificity 98%, PPV 94%, NPV 82%.

Conclusion: RAPIRUN has a high diagnostic value for H. pylori in specificity than serology."

"ABSTRAKHelicobacter pylori diperkirakan menginfeksi lebih dari setengah populasi orang dewasa. Deteksi dini H.pylori sangat diperlukan untuk mencegah berkembangnya infeksi menjadi keganasan lambung. Bentuk coccoid dari H. pylori sulit dideteksi dengan kultur dan histopatologi, namun dapat terdeteksi dengan metode molekuler seperti real-time PCR. Salah satu gen yang dapat digunakan sebagai gen target real-time PCR yaitu 16S rRNA, yang diketahui spesifik dan juga digunakan untuk menganalisis kekerabatan antar strain. Analisis ini bermanfaat untuk melihat penyebaran infeksi H.pylori di dunia. Penelitian ini merupakan penelitian eksperimental laboratorium. Metode pengambilan sampel yang digunakan yaitu, metode consecutive sampling. Biopsi diambil dari 2 antrum dan 2 korpus pada 42 penderita dispepsia untuk pemeriksaan real-time PCR dan histopatologi. Optimasi kondisi real-time PCR meliputi uji volume cetakan DNA, sensitifitas dan spesifisitas teknik, kemudian dilanjutkan aplikasi pada sampel klinis dari biopsi lambung. Delapan dari 11 sampel yang positif dilakukan sekuensing dan analisis filogenetik. Hasil optimasi diperoleh suhu annealing 64?C, konsentrasi primer 0,8 ?M dan konsentrasi probe 0,6 ?M. Ambang batas deteksi real-time PCR untuk mendeteksi jumlah DNA minimal H.pylori yaitu 46 bakteri. Spesifisitas uji reaksi silang real-time PCR ini tidak menunjukkan adanya reaksi silang dengan mikroorganisme lain. Proporsi positif hasil pemeriksaan real-time PCR sebesar 26,2 , sedangkan histopatologi sebesar 11,9 . Pemeriksaan real-time PCR mampu meningkatkan diagnosis sebesar 14,3 dibandingkan pemeriksaan histopatologi. Hasil sekuensing dan analisis filogenetik menunjukkan bahwa strain H.pylori dari sampel memiliki kekerabatan dengan strain Taiwan, India, dan Australia. Kata kunci : H.pylori, histopatologi, real-time PCR, analisis filogenetik

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ABSTRACTHelicobacter pylori infection is estimated infect almost half of the adult population in the world. Early detection of H.pylori is needed to prevent the development of infections into gastric malignancies. The coccoid form of H. pylori is difficult to detect using culture and histopathology but it can be detected by molecular methods such as real time PCR. One of the genes that can be used as a real time PCR target gene is 16S rRNA, which is known to be specific and also used to analyze closely related strain. This analysis were useful to showed the spread of H.pylori infection in the world.This study is an experimental laboratory. The sampling method used is the consecutive sampling method. Biopsy was taken from 2 antrum and 2 corpus in 42 patients with dyspepsia for real time PCR and histopathology examination. Optimization real time PCR conditions include DNA template volume testing, sensitivity and specificity of the technique, followed by application of clinical samples from gastric biopsy. Eight of the 11 positive samples were sequenced and analyzed for phylogenetics pattern. The optimization result obtained annealing temperature 64 C, primer concentration was 0,8 M and probe concentration was 0,6 M. Limit detection of the DNA was 46 bacteria. The specificity of the PCR 39 s real time indicate that there was no cross reaction with other microorganisms. The positive proportion of PCR real time examination was 26.2 , while histopathology was 11.9 . A real time PCR examination was able to improve the diagnosis by 14,3 compared to histopathology examination. Sequencing and phylogenetic analysis results showed that our strain were closely related to Taiwan, India and Australia strains. Keywords H.pylori, histopathology, real time PCR, phylogenetic analysis"

"Latar Belakang: Infeksi Helicobacter pylori merupakan infeksi kronis bakterial yang berhubungan dengan penyakit gastroduodenal. Berdasarkan konsensus Bangkok, pemeriksaan diagnostik infeksi H.pylori hendaknya dilakukan pada semua pasien dispepsia kronis. Urea breath test (UBT) merupakan pemeriksaan referens non-invasif dengan biaya cukup mahal. Rapid test antigen feses merupakan pemeriksaan yang praktis dengan biaya lebih terjangkau. Penelitian ini bertujuan mengevaluasi peran diagnostik rapid test antigen H.pylori dalam feses terhadap UBT pada pasien dispepsia. Metode: Penelitian ini merupakan uji potong lintang terhadap pasien dispepsia di RSUPN Cipto Mangunkusumo selama bulan Agustus-Oktober 2018. Sebanyak 70 subjek diambil secara consecutive sampling dan dilakukan pemeriksaan rapid test SD Bioline H.pylori Ag^® dan Urea [¹³C] Breath Test Kit-Heliforce^®. Hasil: Rerata usia subjek penelitian adalah 46,2 ± 14,23 tahun (18-70 tahun) dan terdapat 17,14% subjek positif terinfeksi H.pylori berdasarkan hasil UBT. Sensitivitas, spesifisitas, nilai prediksi positif, dan nilai prediksi negatif rapid test secara berurutan adalah 41,67%, 100%, 100%, dan 89,23%. Simpulan: Rapid test antigen H.pylori dalam feses memiliki sensitvitas yang kurang baik tetapi memiliki spesifisitas, NPP, dan NPN yang cukup baik; praktis digunakan; dan harganya jauh lebih terjangkau sehingga masih dapat dipertimbangkan untuk digunakan pada daerah dengan keterbatasan ekonomi dan fasilitas.

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Background: Helicobacter pylori infection is a chronic bacterial infection associated with gastroduodenal diseases. Based on the Bangkok consensus, a diagnostic test of H.pylori infection should be carried out in all patients with chronic dyspepsia. Urea breath test (UBT) is a non-invasive reference test with a fairly expensive cost. Stool antigen rapid test is a practical test with a more affordable cost. We aimed to evaluate the diagnostic role of the H.pylori stool antigen rapid test against UBT in dyspeptic patients.

Methods: This was a cross-sectional study of dyspeptic patients at RSUPN Cipto Mangunkusumo during August-October 2018. A total of 70 subjects were taken by consecutive sampling method and tested with rapid test SD Bioline H.pylori Ag^® and Urea [¹³C] Breath Test Kit-Heliforce^®.

Results: The mean age of the subjects was 46.2 ± 14.23 years (18-70 years) and there were 17.14% subjects positively infected with H.pylori based on UBT results. Sensitivity, specificity, positive predictive value, and negative predictive value of the rapid test were 41.67%, 100%, 100%, and 89.23% respectively.

Conclusion: Helicobacter pylori stool antigen rapid test had poor sensitivity but had a good specificity, PPV, and NPV; practical use; and more affordable price so that it could still be considered to be used in areas with economic and facilities limitations."

"Latar Belakang: Diagnosis definitif Helicobacter pylori H.pylori hingga kini masih merupakan masalah. Biakan untuk isolasi dan identifikasi bakteri ini sulit. Uji cepat urease direkomendasikan sebagai uji diagnostik lini pertama pasien dispepsia. Tujuan: Mengembangkan komposisi medium biakan dan deteksi cepat H.pylori pada spesimen biopsi lambung pasien dispepsia. Metode: Desain penelitian merupakan studi potong lintang dan eksperimental laboratorium. Sampel diambil dengan cara consecutive sampling sebanyak 68 spesimen biopsi lambung 34 antrum, 34 korpus, masing-masing untuk biakan dan uji MIU. Sebagai pembanding digunakan histopatologi dan PCR. Mula-mula dilakukan optimasi medium biakan dan MIU konsentrasi merah fenol, pH, urea dan suhu inkubasi. Selanjutnya kondisi optimal yang diperoleh diaplikasikan pada spesimen biopsi pasien dispepsia. Hasil: Medium biakan agar darah Columbia ditambah vankomisin 5 mg / 500 mL dan darah domba 7 belum optimal, namun dapat digunakan untuk isolasi dan identifikasi. Hasil MIU modifikasi sebagai berikut: konsentrasi merah fenol 0,001 ; urea 4 ; pH medium 7; Suhu inkubasi optimal 35-370 C. Proporsi positif hasil uji MIU sebesar 35,29 12/34, biakan 32,35 11/34, PCR 32,35 11/34 dan histopatologi 20,59 7/34. Kesimpulan: Pemeriksaan MIU meningkatkan positivitas hasil pemeriksaan sebesar 14,7 bila dibandingkan dengan histopatologi.

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Background: Until now, definitive diagnostic of H.pylori is still a problem. Culture for isolation and identification of this pathogen is difficult. Rapid urease test is recommended as a first line diagnostic test.

Aim: To obtain optimal composition for culture medium and Motility Indol Urease MIU test for the detection of H. pylori in dyspeptic patient biopsy specimens.

Method: A cross sectional and experimental laboratory study was performed. Sixty eight gastric biopsy samples 34 antrum, 34 corpus were collected by consecutive sampling method for culture and MIU test. Histopathology and PCR were conducted for comparison. Initially, we performed the optimation of culture medium and MIU test phenol red and urea concentration, pH, and temperature. The optimal condition obtained was then applied to the specimens.

Result: Columbia agar supplemented with vancomycin 5 mg 500 mL and 7 sheep blood was unable to create an optimal condition, but it can be used for isolation and identification. Modified MIU was performed by this following condition phenol red 0,001 urea 4 pH 7 incubation temperature 35 37oC. Positive proportion of MIU was 35.29 12 34, culture 32.35 11 34, PCR 32,35 11 34 and histopathology 20.59 7 34.

Conclusion: MIU test was able to improve the positivity rate by 14,7 compared to histopathology."

"Latar Belakang: Diagnosis definitif Helicobacter pylori (H.pylori) hingga kini masih merupakan masalah. Biakan untuk isolasi dan identifikasi bakteri ini sulit. Uji cepat urease direkomendasikan sebagai uji diagnostik lini pertama pasien dispepsia. Tujuan: Mengembangkan komposisi medium biakan dan deteksi cepat H.pylori pada spesimen biopsi lambung pasien dispepsia. Metode: Desain penelitian merupakan studi potong lintang dan eksperimental laboratorium. Sampel diambil dengan cara consecutive sampling sebanyak 68 spesimen biopsi lambung (34 antrum, 34 korpus), masing-masing untuk biakan dan uji MIU. Sebagai pembanding digunakan histopatologi dan PCR. Mula-mula dilakukan optimasi medium biakan dan MIU (konsentrasi merah fenol, pH, urea dan suhu inkubasi). Selanjutnya kondisi optimal yang diperoleh diaplikasikan pada spesimen biopsi pasien dispepsia. Hasil: Medium biakan agar darah Columbia ditambah vankomisin 5 mg/500 mL dan darah domba 7% belum optimal, namun dapat digunakan untuk isolasi dan identifikasi. Hasil MIU modifikasi sebagai berikut: konsentrasi merah fenol 0,001%; urea 4%; pH medium 7; Suhu inkubasi optimal 35-370 C. Proporsi positif hasil uji MIU sebesar 35,29% (12/34), biakan 32,35%(11/34), PCR 32,35%(11/34) dan histopatologi 20,59% (7/34). Kesimpulan: Pemeriksaan MIU meningkatkan positivitas hasil pemeriksaan sebesar 14,7% bila dibandingkan dengan histopatologi.

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Background: Until now, definitive diagnostic of H.pylori is still a problem. Culture for isolation and identification of this pathogen is difficult. Rapid urease test is recommended as a first-line diagnostic test. Aim: to obtain optimal composition for culture medium and Motility-Indol-Urease (MIU) test for the detection of H. pylori in dyspeptic patient biopsy specimens. Method: A cross sectional and experimental laboratory study was performed. Sixty eight gastric biopsy samples (34 antrum, 34 corpus) were collected by consecutive sampling method for culture and MIU test. Histopathology and PCR were conducted for comparison. Initially, we performed the optimation of culture medium and MIU test (phenol red and urea concentration, pH, and temperature). The optimal condition obtained was then applied to the specimens. Result: Columbia agar supplemented with vancomycin 5 mg / 500 mL and 7% sheep blood was unable to create an optimal condition, but it can be used for isolation and identification. Modified MIU was performed by this following condition: phenol red 0,001%; urea 4%; pH 7; incubation temperature 35-37oC. Positive proportion of MIU was 35.29% (12/34), culture 32.35% (11/34), PCR 32,35% (11/34) and histopathology 20.59% (7/34). Conclusion: MIU test was able to improve the positivity rate by 14,7% compared to histopathology. "

"ABSTRACTBackground: early detection of H. pylori is essential to prevent the development of infections into gastric malignancies. The coccoid form of H. pylori is difficult to detect either by culture or histopathology; however, it can be detected using molecular methods, such as real-time PCR. The study was expected to provide new information on the development of H. pylori detection. Methods: a cross-sectional study was conducted at the Gastrointestinal Endoscopy Center of Cipto Mangunkusumo Hospital between October 2016 and August 2017. The sampling method used was consecutive sampling. Biopsy from gastric antrum and corpus were performed in 64 patients. We collected 2 specimens from each site to be examined using real-time PCR and histopathology. Initially, we conducted real-time PCR optimization followed by application of clinical samples from gastric biopsy. Data analysis using McNemars χ2 and Kappa tests. Results: the real-time PCR showed 25% positivity, while the positive proportion of histopathological examination was 14%. Real-time PCR has a sensitivity and specificity 88.9% dan 85.5%, respectively. The McNemars x2 test showed that there is significantly different (p=0.039) between the two tests; kappa value (p=0.561). Conclusion: the real-time PCR examination is more sensitive than histopathology. This technique can improve diagnosis by 11% compared to histopathological examination."