Validation of the 13C-urea breath test for the diagnosis of helicobacter pylori infection in children: a multicenter study

Bazzoli, Franco; Cecchini, Liliana; Corvaglia, Luigi; Dall’Antonia, Martino; Giacomo, Costantino De; Fossi, S.; Casali, L Gobio; Gullini, S.; Lazzari, R; Leggeri, G; Lerro, P.; Valdambrini, V.; Mandrioli, G.; Marani, Miris; Martelli, Paolo; Miano, A.; Nicolini, Gianni; Oderda, Giuseppina; Pazzi, P.; Pozzato, P.; Ricciardiello, Luigi; Roda, Enrico; Simoni, Patrizia; Sottili, S.; Torre, Giuliano; Urso, Luigina; Zagari, Rocco Maurizio

doi:10.1111/j.1572-0241.2000.01836.x

Cited by 80 publications

(62 citation statements)

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“…In this review, five different measuring equipments were used. Eighteen of 28 papers used the traditional isotope ratio mass spectrometer [4,11,18,21,24,30,36,48,51,60,79,86,92,106,119,122,124,127].…”

Section: C-urea Breath Testmentioning

confidence: 99%

Helicobacter pylori diagnostic tests in children: review of the literature from 1999 to 2009

et al. 2009

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The array of tests that can be used for diagnosis of Helicobacter pylori infection is large, and it can be confusing to define which test to use particularly in children where results may not be comparable to those obtained in adult patients. Using PubMed, we reviewed the English literature from January 1999 to May 2009 to identify articles that determined sensitivity and specificity of H. pylori invasive and non-invasive diagnostic tests in children. We excluded articles that presented a review of the literature, abstracts, case reports, or series where children's results could not be separated from adult populations. Of the tissue based methods, rapid urease tests have better sensitivity than histology to detect presence of H. pylori; however, histology can detect the pathology associated with disease including gastritis, intestinal metaplasia, and other conditions that could be the cause of the child's symptoms. Culture of gastric tissues or stool has 100% specificity but sensitivity is low. Of the serologic tests, immunoblot has the best sensitivity. The urea breath tests have >75% sensitivity for detection of H. pylori before and after treatment. Immunoassays in stool using monoclonal antibodies have >95% sensitivity for detection of H. pylori before and after treatment. PCR testing can be performed in tissue and stool samples and can detect genes associated to antibiotic resistance. In summary, the current commercial non-invasive tests have adequate sensitivity and specificity for detecting the presence of H. pylori; however, endoscopy with histopathology is the only method that can detect H. pylori and lesions associated with the infection.

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Section: C-urea Breath Testmentioning

confidence: 99%

Helicobacter pylori diagnostic tests in children: review of the literature from 1999 to 2009

et al. 2009

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“…The stool test based on monoclonal antibodies has proved to be highly accurate in all age groups (13)(14)(15), but the specificity of the [ 13 C]UBT varies from 82% to 100% for young children (9)(10)(11)(12). However, studies of this subject are scarce and have not included large enough numbers of infants and toddlers to obtain reliable results.…”

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confidence: 99%

“…The noninvasive [ 13 C]urea breath test ([ 13 C]UBT) (9)(10)(11)(12) and stool antigen test (13)(14)(15) are very reliable for the diagnosis of H. pylori infection in children older than 6 years. The stool test based on monoclonal antibodies has proved to be highly accurate in all age groups (13)(14)(15), but the specificity of the [ 13 C]UBT varies from 82% to 100% for young children (9)(10)(11)(12).…”

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confidence: 99%

Helicobacter pylori Infection in Infants and Toddlers in South America: Concordance between [ ¹³ C]Urea Breath Test and Monoclonal H. pylori Stool Antigen Test

et al. 2013

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H elicobacter pylori infection is acquired primarily in early childhood and is predominantly transmitted within families, infected mother and siblings being the most common familial source of the microorganism (1-5). Infants and toddlers most frequently acquire and lose the infection (3, 6), but there are substantial knowledge gaps in respect to the predictors of initial acquisition, as well as the persistence of the infection, in this age group. In addition, in children, H. pylori infection has been associated with iron deficiency anemia, diarrheic disease, and impairment of growth, weight, and cognitive functions (7,8). Thus, a simple and reliable noninvasive test to detect H. pylori infection in this age group is required, especially in developing countries, where the prevalence of H. pylori infection is very high.The noninvasive [ 13 C]urea breath test ([ 13 C]UBT) (9-12) and stool antigen test (13-15) are very reliable for the diagnosis of H. pylori infection in children older than 6 years. The stool test based on monoclonal antibodies has proved to be highly accurate in all age groups (13-15), but the specificity of the [ 13 C]UBT varies from 82% to 100% for young children (9-12). However, studies of this subject are scarce and have not included large enough numbers of infants and toddlers to obtain reliable results. Furthermore, different "gold standard" tests have been used to validate the [ 13 C]UBT, and most studies are in developed countries, where the prevalence of infection is very low (11,12,16,17).To validate noninvasive tests for diagnosis of H. pylori infection, the indicated "gold standard" includes at least two invasive tests, which is a difficult task with young children due to the current rarity of symptomatic H. pylori infection in this period of life. In addition, as stated by Goodman and Correa, validation using invasive tests has some limitations; recent short-term colonization and patchy distribution of the bacterium in the gastric mucosa may decrease the sensitive of biopsy-based tests in very young children (18). Such problems currently restrict epidemiological investigations of the acquisition of H. pylori infection in infants and toddlers in developing-country settings.The aim of this study was to investigate whether the two independent noninvasive tests for H. pylori infection diagnosis, the [ 13 C]UBT and monoclonal stool antigen test, have good concordance in young children. For that, we evaluated a cohort of infants and toddlers living in impoverished regions of two developing countries in South America. Our hypothesis was that if the [ 13 C]UBT and monoclonal stool antigen test had good agreement in infants and toddlers, either of the two noninvasive tests could be used for the diagnosis of H. pylori in this age group. We also aimed to investigate causes linked to discordant results between the two tests.

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“…[8][9][10][11][12][13][14][15][16][17] These studies have shown that the UBT is reliable for detecting H. pylori infection. However, reports on the role of the UBT in the assessment of eradication therapy and in the followup evaluation of patients post-treatment have been relatively few.…”

Section: Introductionmentioning

confidence: 99%

A 13 C-urea breath test in children with Helicobacter pylori infection: assessment of eradication therapy and follow-up after treatment

Yoshimura

Tajiri

Sawada

et al. 2001

Journal of Gastroenterology

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Validation of the 13C-urea breath test for the diagnosis of helicobacter pylori infection in children: a multicenter study

Abstract: The 13C-UBT is an accurate test for the detection of H. pylori infection also in children. Administration of 50 mg of 13C-urea, a fatty test meal, and breath sampling at 30 min appears to be the most convenient protocol.

Cited by 80 publications

References 14 publications

Helicobacter pylori diagnostic tests in children: review of the literature from 1999 to 2009

Helicobacter pylori diagnostic tests in children: review of the literature from 1999 to 2009

Helicobacter pylori Infection in Infants and Toddlers in South America: Concordance between [ ¹³ C]Urea Breath Test and Monoclonal H. pylori Stool Antigen Test

A 13 C-urea breath test in children with Helicobacter pylori infection: assessment of eradication therapy and follow-up after treatment

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Validation of the 13C-urea breath test for the diagnosis of helicobacter pylori infection in children: a multicenter study

Abstract: The 13C-UBT is an accurate test for the detection of H. pylori infection also in children. Administration of 50 mg of 13C-urea, a fatty test meal, and breath sampling at 30 min appears to be the most convenient protocol.

Cited by 80 publications

References 14 publications

Helicobacter pylori diagnostic tests in children: review of the literature from 1999 to 2009

Helicobacter pylori diagnostic tests in children: review of the literature from 1999 to 2009

Helicobacter pylori Infection in Infants and Toddlers in South America: Concordance between [ 13 C]Urea Breath Test and Monoclonal H. pylori Stool Antigen Test

A 13 C-urea breath test in children with Helicobacter pylori infection: assessment of eradication therapy and follow-up after treatment

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Helicobacter pylori Infection in Infants and Toddlers in South America: Concordance between [ ¹³ C]Urea Breath Test and Monoclonal H. pylori Stool Antigen Test