Additional file 1
H. pylori phenotypically and molecular characterization 
Biopsies were collected and transferred in tayo glycolate broth within 5 hours. The samples grinded, and directly cultured on modified Brucella Agar S׀ Media (Merck, Darmstadt, Germany) with 5% horse blood, 5-10% fetal calf serum (FCS), 2% Skirrow supplement (Quelab, Montreal, Quebec, Canada), and 5 mg/L Amphotripcine B Sigma-Aldrich (St. Louis, MO, USA), incubated under microaerophilic condition for a-week. Suspicious colonies were confirmed by bacterial enzymatic activities; Urease, oxidase and catalase tests. Antimicrobial drug resistance (ADR) was measured by agar dilution method. Briefly, bacterial density adjusted to be ~ 108 cfu/ml and introduced on modified Brucella Agar Sǁ plates (Merck, Darmstadt, Germany) with 10% horse blood, 10% FCS and, 5 mg/L amphotripcine B and Clarithromycin with the concentration range of 0.016–256 mg/l, consequently inoculated plates kept under microaerophilic condition for 3 days. Based on clinical and laboratory standards institute (CLSI) the cutoff value for the resistance were MICs ≥1 mg/L. DNA extraction performed according to Favarogene mini kit (Taiwan) manufacture 's direction and stored in -20°C until tested.   Subsequently, histopathological report of the patients (H. pylori positive) recorded and compared to molecular recognized H. pylori positive infected subject. 23S rRNA target gene selected to infected subject identification by polymerase chain reaction (PCR). The reagents were prepared in the final volume 25 μL made up 13 μl of DDW, 8μl of 2x Master Mix (Amplicon, Spain), 2μl 23S rRNA F/R primers mixture (Metabion Germany), finally 2μl of analyte per tube. Amplification steps follows as: initial denaturation at 95°C for 5 minutes, 42 cycles of duplication; denaturation at 95 °C for 60 s, annealing step at 56°C for 45 s, and elongation at 70°C for 60 s. 0.5% agarose gel in a TBE buffer (0.5x), 60 minutes for 90 v was utilized for molecular verification of 147bp amplicon length.