Diagnostic Accuracy of PCR-Based Detection Tests for Helicobacter Pylori in Otitis Media: A Meta-Analysis

Abstract

Background and objectives: Helicobacter pylori (H. Pylori) infection has serious consequences such as peptic ulcers and gastric cancer. Histologic identification of organisms remains the gold standard in the diagnosis of H. pylori. This meta-analysis reviewed the overall diagnostic accuracy of polymerase chain reaction (PCR) vs histology of H. pylori infection in the patients with otitis media with effusion (OME). Methods:Medline, Scopus and ISI web of science were systematically searched. Articles meeting the selection criteria were retrieved for the data collection and analysis. Diagnostic odds ratio (DOR) and symmetric summary receiver operating characteristic (sROC) of OME -associated .H. pylori infection was estimated for each study. The PCR techniques were compared to the histological tests as the gold standard in .diagnosing H. pylori infection. Results:We included eight relevant studies compromising 259 case of OME. The pooled sensitivity and specificity of PCR compared to the histological diagnosis of H. Pylori infection in patient with OME were 71% (95%CI: 61% -80%, I2 : 0.0%) and 81% (95%CI: 76% -86%, I 2 : 59.9%), respectively. Pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLR) for PCR were 3.61(95%CI: 2.34 -5.59, I2 : 44.5%) and 0.42 (95%CI: 0.31 -0.57, I 2 : 0.1%), respectively. For DOR analysis, the pooled accuracy of PCR was I 2 : 0.0%) in diagnosing H. Pylori infection. Conclusions:This review showed statistically significant differences in the diagnostic accuracy between the PCR and histological tests. This meta-analysis also suggests a higher sensitivity and specificity of PCR-based molecular diagnostic of H. Pylori infection in OME patients compared to the histological tests.

Pangenome Analysis of Helicobacter pylori Isolates from Selected Areas of Africa Indicated Diverse Antibiotic Resistance and Virulence Genes

“…A case in point is the vacA gene which is much associated with clarithromycin and tinidazole resistance and the cag A gene which is also associated with tinidazole resistance [ 61 ]. Strong association between amoxicillin resistance and the hop gene of the bacterium has been reported [ 62 ]. Ureases have been reported to be strongly associated with metronidazole resistance in the bacterium [ 63 ], while babA and babB genes have been implicated in the H. pylori erythromycin resistance [ 64 ].…”

Molecular Detection of Helicobacter pylori in Children with Otitis Media with Effusion at Assiut University and Sohag Teaching Hospitals

“…The mean age of our study group was 6.73±2. 16. In contrast, another study was done on a wider variety of ages, with a mean age of 25.6 years 10 .…”

“…Therefore, PCR is considered a rapid, sensitive, specific, low cost and useful method for detection of H. pylori 15 . Several studies reported the relationship between H. pylori and the pathogenesis of different upper aerodigestive tract diseases, especially when an induced inflammation was done in the middle ear of mice by inoculating H. pylori whole-cell protein lysate 16 . These findings raised the question whether H. pylori play a causative role in OME.…”

Correlation Between Tympanosclerosis and Helicobacter pylori

“…Many studies have been conducted on otitis media with effusion and on its correlation with H. pylori ( 15 , 17 - 19 ). However, the correlation between chronic suppurative otitis media and its various aspects, such as tympanosclerosis in which deposition of acellular hyaline and calcified deposits accumulate in the lamina propria of the middle ear has not been sufficiently studied ( 20 , 21 ).…”