New Immunoassay in Stool Provides an Accurate Noninvasive Diagnostic Method for<i>Helicobacter pylori</i>Screening in Children

Braden, Barbara; Posselt, Hans-Georg; Ahrens, Peter; Kitz, Richard J.; Dietrich, Christoph F.; Caspary, W. F.

doi:10.1542/peds.106.1.115

Cited by 81 publications

(57 citation statements)

References 21 publications

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“…13 C]urea breath test ( 13 C-UBT) and a new developed immunoassay for the detection of Helicobacter pylori antigens in stool, the H. pylori stool antigen test (HpSA) (3), are noninvasive tests for H. pylori diagnosis.…”

Section: The [mentioning

confidence: 99%

Evaluation of [ ¹³ C]Urea Breath Test and Helicobacter pylori Stool Antigen Test for Diagnosis of H. pylori Infection in Children from a Developing Country

Cardinali¹,

Rocha²,

Rocha³

et al. 2003

J Clin Microbiol

103

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The [13 C]urea breath test ( 13 C-UBT) and Helicobacter pylori stool antigen test (HpSA) for the diagnosis of H. pylori infection in children were validated. The sensitivity, specificity, and positive and negative predictive values were 93.8, 99.1, 97.8, and 98.0%, respectively, for the 13 C-UBT and 96.9, 100, 100, and 98.0%, respectively, for HpSA. Both tests are appropriate for diagnosing H. pylori infection in children. The [13 C]urea breath test ( 13 C-UBT) and a new developed immunoassay for the detection of Helicobacter pylori antigens in stool, the H. pylori stool antigen test (HpSA) (3), are noninvasive tests for H. pylori diagnosis.Although the 13 C-UBT has a good sensitivity for the diagnosis of the infection in all ages, low specificity for very young children has been found (6). With respect to the stool test, low sensitivity for this age group has been also reported (2, 10). Thus, we aimed to validate the 13 C-UBT and HpSA for the diagnosis of H. pylori infection in children.We studied prospectively 210 consecutive children aged 1 to 18 years who underwent esophagogastroduodenoscopy for investigation of gastric complaints. This project was approved by the Ethics Committee of our institution.At endoscopy, biopsy specimens were obtained from the antral and oxyntic gastric mucosa for culture, urease test, and histology. Children were considered to be H. pylori positive if at least two of the three tests were positive or if the culture alone was positive. They were considered negative if all tests were negative.The 13 C-UBT was performed on fasting children within 1 week after endoscopy. The children received 200 ml of orange juice containing 75 mg of [ 13 C]urea (or 100 ml containing 50 mg for those Ͻ30 kg). Breath samples at baseline and after 30 min were analyzed with a nondispersive infrared spectrometer (NDIRIS; Wagner Analysen Technik, Bremen, Germany). The results were considered positive when delta over baseline (DOB) was Ͼ4.0‰.Stool samples, collected on the occasion of the endoscopy, were maintained at Ϫ20°C for up 1 year before testing. HpSA (Premier Platinum HpSA; Meridian Diagnostic, Cincinnati, Ohio) was performed according to the manufacturer's recommendation, slightly modified: instead of a stick, a 10-l disposable loop was used to dilute stool samples, as proposed by Oderda et al. (9), and the plates were washed exhaustively to remove unbound material.Among the 210 children enrolled, 167 underwent the 13 C-UBT but 6 children were excluded (4 had only one positive test and 2 had equivocal results in the 13 C-UBT). The remaining 161 children (76 boys; mean age, 8.6 Ϯ 3.8 years; range, 1 to 18 years) were included in the final analysis (48 were H. pylori positive and 15 had peptic ulcer). The 13 C-UBT was positive for 45 of 48 infected children and for one of the 113 noninfected ones (Table 1). The three children with false-negative 13 C-UBT results were a 5-year-old boy (DOB ϭ 0.3), a 9-yearold girl (DOB ϭ 0.5), and a 14-year-old girl (DOB ϭ 0.2). The cultures for all of them were positiv...

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Section: The [mentioning

confidence: 99%

Evaluation of [ ¹³ C]Urea Breath Test and Helicobacter pylori Stool Antigen Test for Diagnosis of H. pylori Infection in Children from a Developing Country

Cardinali¹,

Rocha²,

Rocha³

et al. 2003

J Clin Microbiol

103

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“…Many studies support the diagnostic value of H. pylori antigens in stool samples by enzyme immunoassay (EIA) (8).This test was approved in 1998 for both diagnosis and monitoring the response to treatment of H. pylori infection in adult patients (9). Recently, a study performed by Falsafi T et al using stool test for detection of H. pylori antigen in children and adolescents from Tehran demonstrated a high prevalence of infection (70%) in cases with a family history of H. pylori infection or peptic ulcer disease (10).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Helicobacter pylori Infection evaluated by Stool antigen test in Khuzestan Province since September to October 2009, south-west of Iran: a population based study

Talaiezadeh

Borhani

Moosavian

et al. 2013

Jundishapur J Microbiol

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Background: Although infection with Helicobacter pylori is a global health problem, its prevalence is different among countries. Serologic tests for the diagnosis of H. pylori infection are limited by low accuracy rates and lack of validation. Recent studies indicate that the stool antigen test has an acceptable level of accuracy. Objectives: Our objective was to investigate the prevalence of H. pylori infection in Khuzestan province, south-west of Iran by stool antigen test and to evaluate possible risk factors for the H. pylori infection. Patients and Methods: In this study, from September to October 2009, 861 healthy individuals aged 0-80 years were sampled by cluster sampling from 4.5 million inhabitants of the province. Infection with H. pylori was evaluated by detection of H. pylori antigens in stool (HpSA). Epidemiologic data of each subject were determined by filling up a questionnaire. Results: The overall HpSA positivity was (53.5%, CI 95% = 50.2-56.84%) and the mean age of infected cases was greater than that of non-infected ones (29.2 yrs vs. 24.5 yrs) (P < 0.001). HpSA positivity increased with age. The peak prevalence was reached in the 41-50 years age group (66%). No association was detected between H. pylori positivity and gender. Additionally, there was no significant relationship between H. pylori infection and previous hospital admission, gastrointestinal symptoms, and living area (P > 0.05). Conclusions: H. pylori infection is highly prevalent (57%) in Khuzestan province, south-west of Iran. Low educational levels, low socioeconomic jobs, and increasing age were related to high prevalence of H. pylori infection in this area.

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“…In another serology based Turkish study held in asymptomatic subjects, 30% of the teenagers and 70% of the adults already acquire H. pylori infection (Us and Hascelik 1998). In previous studies, the sensitivity and specificity of the HpSA test were found to be comparable to the UBT (Casswall et al 1999;McNamara et al 1999;Braden et al 2000), but there are only a few studies investigating the correlation between HpSA OD values and gastric inflammation scores or H. pylori load. The reaction velocity of the biopsy urease test, the ∆ 13 C value of the UBT and the OD value of the HpSA test correlated well with H. pylori density in the stomach (Labenz et al 1996;Chou et al 1997;Chang et al 2002).…”

Section: Discussionmentioning

confidence: 96%

Quantitative Correlation of Helicobacter pylori Stool Antigen (HpSA) Test with the Severity of H. pylori-Related Gastritis

Adiloğlu

Işler

Goren

et al. 2007

Tohoku J. Exp. Med.

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The Helicobacter pylori (H. pylori) load in both stomach and stool and the resulting severity of gastritis are important criteria in validating the status of H. pylori infection. We aimed to assess the reliability of the H. pylori stool antigen (HpSA) test for the primary diagnosis of H. pylori infection by calculating the best cut-off value to obtain the highest sensitivity and specificity in dyspeptic patients. We also investigated the correlation of HpSA test with the severity of gastritis and H. pylori load. The H. pylori statuses of 95 patients were evaluated by the positivity of both rapid urease test and microscopic detection of H. pylori in biopsy specimens, 88 subjects of whom were H. pylori positive. The sensitivity and specificity of the HpSA test were 51.1% (45/88) and 100% (7/7), respectively, according to the manufacturer's recommended cut-off value of 0.16. However, with the best cut-off value of 0.048, calculated by receiver operator characteristics analysis, the sensitivity of the test increased to 92.0% (81/88) with the same specificity. High values of the HpSA test were correlated with high scores of corpus H. pylori load and the severity of antrum and corpus inflammation ( p < 0.05). With the best cut-off value of the HpSA test, the primary diagnosis of H. pylori infection can be made with higher sensitivity and specificity. The HpSA test is a helpful tool that evaluates the severity of H. pylori infection and the degree of gastric inflammatory activity and gastric H. pylori load.

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New Immunoassay in Stool Provides an Accurate Noninvasive Diagnostic Method forHelicobacter pyloriScreening in Children

Abstract: The new, noninvasive, low-cost H pylori antigen test in stool can replace the UBT for detection of H pylori infection in children with comparable reliability and accuracy.

Cited by 81 publications

References 21 publications

Evaluation of [ ¹³ C]Urea Breath Test and Helicobacter pylori Stool Antigen Test for Diagnosis of H. pylori Infection in Children from a Developing Country

Evaluation of [ ¹³ C]Urea Breath Test and Helicobacter pylori Stool Antigen Test for Diagnosis of H. pylori Infection in Children from a Developing Country

Prevalence of Helicobacter pylori Infection evaluated by Stool antigen test in Khuzestan Province since September to October 2009, south-west of Iran: a population based study

Quantitative Correlation of Helicobacter pylori Stool Antigen (HpSA) Test with the Severity of H. pylori-Related Gastritis

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New Immunoassay in Stool Provides an Accurate Noninvasive Diagnostic Method forHelicobacter pyloriScreening in Children

Abstract: The new, noninvasive, low-cost H pylori antigen test in stool can replace the UBT for detection of H pylori infection in children with comparable reliability and accuracy.

Cited by 81 publications

References 21 publications

Evaluation of [ 13 C]Urea Breath Test and Helicobacter pylori Stool Antigen Test for Diagnosis of H. pylori Infection in Children from a Developing Country

Evaluation of [ 13 C]Urea Breath Test and Helicobacter pylori Stool Antigen Test for Diagnosis of H. pylori Infection in Children from a Developing Country

Prevalence of Helicobacter pylori Infection evaluated by Stool antigen test in Khuzestan Province since September to October 2009, south-west of Iran: a population based study

Quantitative Correlation of Helicobacter pylori Stool Antigen (HpSA) Test with the Severity of H. pylori-Related Gastritis

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Evaluation of [ ¹³ C]Urea Breath Test and Helicobacter pylori Stool Antigen Test for Diagnosis of H. pylori Infection in Children from a Developing Country

Evaluation of [ ¹³ C]Urea Breath Test and Helicobacter pylori Stool Antigen Test for Diagnosis of H. pylori Infection in Children from a Developing Country