Accuracy of Diagnostic Tests for<i>Helicobacter pylori:</i>A Reappraisal

Calvet, Xavier; Sánchez-Delgado, Jordi; Montserrat, A.; Lario, Sergio; Ramírez‐Lázaro, María José; Quesada, Mariela; Casalots, Àlex; Suarez, David L.; Campo, Rafel; Brullet, Enric; Junquera, Félix; Sanfeliú, Isabel; Segura, Ferrán

doi:10.1086/598198

Cited by 100 publications

(104 citation statements)

References 39 publications

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“…Some studies have also reported high false-positive rates for UBT in non-bleeding patients in some specific settings [32]. We are aware of this limitation of our study, although other authors have found this unexpected falsepositive rate and low specificity [33]. Technical aspects in the procedure like pretreatment with citric acid should be improved in order to increase these suboptimal results [34].…”

Section: Discussionmentioning

confidence: 75%

Accuracy of Urea Breath Test Performed Immediately After Emergency Endoscopy in Peptic Ulcer Bleeding

et al. 2012

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Section: Discussionmentioning

confidence: 75%

Accuracy of Urea Breath Test Performed Immediately After Emergency Endoscopy in Peptic Ulcer Bleeding

et al. 2012

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“…Amongst the non invasive tests are serologic test for antibodies, faecal bacteria detection and urea breath test [19]. The urea breath test is based on the generation of ammonia by bacteria urease.…”

Section: Discussionmentioning

confidence: 99%

Histopathological Pattern of Endoscopic Gastric Biopsy in a District Hospital in Nigeria: A Review of 118 Consecutive Cases

Duduyemi¹,

Ojo²,

Olaomi³

et al. 2014

AJMBR

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Background: The use of endoscopes for visualization of gastric mucosa has improved over times and in taking biopsy for histology. The study sets out to determine the histopathological pattern of gastritis in dyspeptic patients and correlate the histological detection of H. pylori with that of urease breath test (UBT). Method: Prospective study of 118 consecutive patients with chronic dyspepsia who underwent upper gastrointestinal endoscopic examination and UBT using heliprobe. Biopsy of gastric antrum were taken at endoscopy and sent for histopathological analysis. Routine H&E and Giemsa stains were used. Results were recorded and analysed on the basis of sex, age, histology and UBT for H. pylori. Result: There were 118 patients who had endoscopy comprising 58 males and 60 females with male to female ratio of 1:1. Histology revealed varying degrees of chronic gastritis with or without H. pylori, activity, metaplasia, ulceration and dysplasia. Sixty eight (61%) of our patients were positive for H. pylori histologically. Of the first consecutive 66 patients, histology showed 38(57.6%) positive and 28(42.6%) negative; UBT, 46(69.6%) were positive for H. pylori and 20(30.4%) negative. There was a strong correlation between the true positive and true negative patients for the first 66 consecutive cases for both histology and UBT based diagnosis for detecting H. pylori. (Correlation coefficient=0.862, p=0.01). Conclusion: The study showed that histology and UBT are both useful for H. pylori detection. Large multi centre studies should be done to adopt the non-invasive UBT in resource poor economies for the eradication of H. pylori.

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“…In a previous study, we found a very high rate of false-positive results and low specificity with a commercially available urea breath test (UBT), specifically UBiT-100 mg (Otsuka, Barcelona, Spain), for Helicobacter pylori (H. pylori) when compared with the combination of histology, stool test, rapid urease test (RUT) and culture. 1 As this finding was totally unexpected, we performed a number of control measurements to confirm its validity. The analysis led us to hypothesize that the false-positive results may be attributable to the omission of the pre-administration of citric acid, within the UBiT protocol.…”

Section: Introductionmentioning

confidence: 88%

Occult H. pylori infection partially explains ‘false‐positive’ results of ¹³ C‐urea breath test

et al. 2015

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Background: In a previous study, UBiT-100 mg, (Otsuka, Spain), a commercial 13 C-urea breath test omitting citric acid pretreatment, had a high rate of false-positive results; however, it is possible that UBiT detected low-density 'occult' infection missed by other routine reference tests. We aimed to validate previous results in a new cohort and to rule out the possibility that false-positive UBiT were due to an 'occult' infection missed by reference tests. Methods: Dyspeptic patients (n ¼ 272) were prospectively enrolled and UBiT was performed, according to the manufacturer's recommendations. Helicobacter pylori infection was determined by combining culture, histology and rapid urease test results. We calculated UBiT sensitivity, specificity, positive and negative predictive values (with 95% CI). In addition, we evaluated 'occult' H. pylori infection using two previously-validated polymerase chain reaction (PCR) methods for urease A (UreA) and 16 S sequences in gastric biopsies. We included 44 patients with a false-positive UBiT, and two control groups of 25 patients each, that were positive and negative for all H. pylori tests. Results: UBiT showed a false-positive rate of 17%, with a specificity of 83%. All the positive controls and 12 of 44 patients (27%) with false-positive UBiT were positive for all two PCR tests; by contrast, none of our negative controls had two positive PCR tests. Conclusions: UBiT suffers from a high rate of false-positive results and sub-optimal specificity, and the protocol skipping citric acid pre-treatment should be revised; however, low-density 'occult' H. pylori infection that was undetectable by conventional tests accounted for around 25% of the 'false-positive' results.

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Accuracy of Diagnostic Tests forHelicobacter pylori:A Reappraisal

Cited by 100 publications

References 39 publications

Accuracy of Urea Breath Test Performed Immediately After Emergency Endoscopy in Peptic Ulcer Bleeding

Accuracy of Urea Breath Test Performed Immediately After Emergency Endoscopy in Peptic Ulcer Bleeding

Histopathological Pattern of Endoscopic Gastric Biopsy in a District Hospital in Nigeria: A Review of 118 Consecutive Cases

Occult H. pylori infection partially explains ‘false‐positive’ results of ¹³ C‐urea breath test

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Accuracy of Diagnostic Tests forHelicobacter pylori:A Reappraisal

Cited by 100 publications

References 39 publications

Accuracy of Urea Breath Test Performed Immediately After Emergency Endoscopy in Peptic Ulcer Bleeding

Accuracy of Urea Breath Test Performed Immediately After Emergency Endoscopy in Peptic Ulcer Bleeding

Histopathological Pattern of Endoscopic Gastric Biopsy in a District Hospital in Nigeria: A Review of 118 Consecutive Cases

Occult H. pylori infection partially explains ‘false‐positive’ results of 13 C‐urea breath test

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Occult H. pylori infection partially explains ‘false‐positive’ results of ¹³ C‐urea breath test