Non-invasive diagnostic tests for<i>Helicobacter pylori</i>infection

Best, Lawrence; Takwoingi, Yemisi; Siddique, Sulman; Selladurai, Abiram; Gandhi, Akash; Low, Benjamin E.; Yaghoobi, Mohammad; Gurusamy, Kurinchi Selvan

doi:10.1002/14651858.cd012080.pub2

Cited by 153 publications

(181 citation statements)

References 1,110 publications

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“…43 A preliminary study from Brazil demonstrated that a 13 C-urea substrate synthesized by a local company could achieve the same performance in the UBT for the diagnosis of H. pylori infection as the substrate produced by foreign biotechnology companies. 45 44 Finally, Best et al performed a diagnostic test accuracy review on non-invasive diagnostic tests (UBT, serology, and stool antigen tests, SAT) for H. pylori infection.…”

Section: Urea Breath Test (Ubt)mentioning

confidence: 99%

Review: Diagnosis of Helicobacter pylori infection

et al. 2019

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Endoscopic imaging of the stomach is improving. In addition to narrow band imaging, other methods, for example, blue light imaging and linked color imaging, are now available and can be combined with artificial intelligence systems to obtain information on the gastric mucosa and detect early gastric cancer. Immunohistochemistry is only recommended as an ancillary stain in case of chronic active gastritis without Helicobacter pylori detection by standard staining, and recommendations to exclude false negative H. pylori results have been made. Molecular methods using real‐time PCR, droplet digital PCR, or amplification refractory mutation system PCR have shown a high accuracy, both for detecting H. pylori and for clarithromycin susceptibility testing, and can now be used in clinical practice for targeted therapy. The most reliable non‐invasive test remains the 13C‐urea breath test. Large data sets show that DOB values are higher in women and that the cut‐off for positivity could be decreased to 2.74 DOB. Stool antigen tests using monoclonal antibodies are widely used and may be a good alternative to UBT, particularly in countries with a high prevalence of H. pylori infection. Attempts to improve serology by looking at specific immunodominant antigens to distinguish current and past infection have been made. The interest of Gastropanel® which also tests pepsinogen levels was confirmed.

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Section: Urea Breath Test (Ubt)mentioning

confidence: 99%

Review: Diagnosis of Helicobacter pylori infection

et al. 2019

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“…Polymerase chain reaction (PCR) methodology has not been adopted as a routine test because of its technical demands and price compared to conventional tests. The common objection is the risk of false‐negative results due to mutations and false positives when nonspecific primers are used . The source of this opinion is an article by Sugimoto et al, who examined the detection limits for 26 PCRs (with different primers) using biopsy and saliva DNA samples when compared to data obtained from culture and histology results.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic reliability of nested PCR depends on the primer design and threshold abundance ofHelicobacter pyloriin biopsy, stool, and saliva samples

et al. 2020

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Background The aim of this work was to find a reliable nested PCR for the detection of Helicobacter pylori in biopsy, stool, and saliva specimens. Materials and Methods Novel nested PCR was elaborated and validated on 81 clinical biopsy, stool, and saliva samples from the same individual and compared to available H pylori assays: histology, rapid urease test (RUT), stool antigen test (SAT), 13C‐urea breath test (UBT). Results The efficiency and selectivity of 17 published nested polymerase chain reactions (PCR) available for Helicobacter pylori detection were re‐evaluated. Most of them had serious limitations and mistakes in primer design. Hence, we elaborated a nested PCR for the unambiguous identification of H pylori in biopsy, stool, and saliva, using primers targeted to variable regions of the 16S ribosomal RNA (rRNA) gene. Moreover, we determined the detection limit by adding a known number of cells. This number was as low as 0.5 cells in a PCR vial, but due to the DNA isolation procedures, it required 1‐5 × 103 cells/g or ml of specimen. The sensitivity for nested PCR from stomach biopsies was on the same scale as 13C‐UBT (93.8%), but it was much lower in amplifications from stool (31.3%). Sequencing of all obtained PCR products exclusively confirmed H pylori‐specific DNA sequences. Conclusions Elaborated nested PCR assay can serve as an auxiliary method for controversial samples (patients with bleeding or taking proton‐pump inhibitor) in laboratories with basic equipment. The sensitivity and specificity for the amplification from gastric biopsies was almost like 13C‐UBT. Despite the good sensitivity, the threshold occurrence and the ability to survive in the oral cavity aside from and independent of the stomach is the reason why H pylori DNA cannot be reliably detected in saliva, stool, and some biopsy samples.

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“…The latest H. pylori prevalence study in Thailand was reported in March 2018, which varied from 21 to 54%, but this study was conducted using expert opinions. 3,6,8,9 Currently, there are many recommended regimens in the guidelines for treating H. pylori infection. 6 Although the study is a systematic review, the prevalence was assessed from only one study in Thailand, with only 179 participants, using stool antigen as the diagnostic method; hence, it is not an appropriate representation of Thai populations.…”

Section: Introductionmentioning

confidence: 99%

Real‐world data of Helicobacter pylori prevalence, eradication regimens, and antibiotic resistance in Thailand, 2013–2018

et al. 2019

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Background and Aim Helicobacter pylori is a class I carcinogen. Nowadays, the problem of antibiotic resistance is increasing worldwide. The latest prevalence rates of infection and resistant status in Thailand vary or are out of date. Our aims are to identify the current prevalence and antibiotic resistance patterns in Thailand and to suggest regimens for treatment‐naive and ‐resistant patients. Methods This descriptive retrospective study was conducted, using a urea breath test, on patients in King Chulalongkorn Memorial Hospital between 2013 and 2017. They were categorized into the diagnostic group and posttreatment group. Specimens from some patients were cultured to identify the antibiotic‐resistant pattern. Results There were 1894 patients included in our study. The prevalence of H. pylori infection in dyspeptic patients was 28.4%. Of 1258 patients, 1165 (92.61%) responded to initial treatment. The 95 patients who failed to respond could respond to second‐line treatment of longer period, at higher doses, or using other antibiotics (success rate 68.42%). There were 21.43, 14.29, and 10.71% of patients resistant to ciprofloxacin, metronidazole, and clarithromycin, respectively. However, no patients resistant to amoxicillin, tetracycline, and levofloxacin were found. Conclusion The prevalence of H. pylori infection in Thailand has increased slightly. Initial regimens (triple therapy or sequential therapy or quadruple therapy) can be effective for the eradication of H. pylori infection, with a success rate of > 90%. For patients who failed to respond to initial triple therapy, using a longer duration of triple therapy or changing to quadruple therapy could be a good alternative. The resistance rates of amoxicillin, metronidazole, levofloxacin, and tetracycline are declining, but those of clarithromycin and ciprofloxacin are increasing.

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Non-invasive diagnostic tests forHelicobacter pyloriinfection

Cited by 153 publications

References 1,110 publications

Review: Diagnosis of Helicobacter pylori infection

Review: Diagnosis of Helicobacter pylori infection

Diagnostic reliability of nested PCR depends on the primer design and threshold abundance ofHelicobacter pyloriin biopsy, stool, and saliva samples

Real‐world data of Helicobacter pylori prevalence, eradication regimens, and antibiotic resistance in Thailand, 2013–2018

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