scholarly journals Use of LARA-urea Breath Test in diagnosis ofHelicobacter pyloriInfection in Children and Adolescents: A Preliminary Study

2003 ◽  
Vol 17 (12) ◽  
pp. 701-706 ◽  
Author(s):  
Andrew S Day ◽  
Sander Veldhuyzen van Zanten ◽  
Anthony R Otley ◽  
Linda Best ◽  
AnneMarie Griffiths ◽  
...  
Keyword(s):  
Urea Breath Test ◽  
Testing Method ◽  
Breath Testing ◽  
Dyspeptic Symptoms ◽  
Gastric Biopsies ◽  
Stool Antigen ◽  
H Pylori ◽  
Antigen Testing ◽  
Noninvasive Tests ◽  
Urea Breath Testing

BACKGROUND: An accurate diagnosis ofHelicobacter pyloriinfection in children currently relies upon histological assessment or culture of gastric biopsies obtained at endoscopy. Noninvasive testing would permit simpler assessment of children with dyspeptic symptoms. The primary aim of the present study was to prospectively evaluate a novel urea breath testing method in children undergoing diagnostic assessment of dyspeptic symptoms and secondarily to consider the roles of other noninvasive tests in these children.METHODS: Laser associated ratio analysis (LARA)-13C urea breath testing was performed on children presenting with upper gastrointestinal symptoms for diagnostic endoscopy. Serum and stool were collected for performance of serology and stool antigen testing, respectively. Histology and culture of endoscopic biopsies of the gastric antrum were used to establishH pyloriinfection status.RESULTS: Eight (36%) of 22 children wereH pylori-positive by histology or culture of gastric biopsies. Urea breath testing showed a sensitivity of 75%, but specificity of 100%. The deletion of a test meal from the urea breath test protocol in eight patients did not alter the utility of the test. Serology provided sensitivity of 87.5%, but a specificity of only 75%. Stool antigen testing in eight available samples provided sensitivity of 50% and specificity of 100%.CONCLUSIONS: The LARA-urea breath testing method provided less sensitivity in this group of children than suggested from previous studies. However, urea breath testing in children is easy to complete and provides rapid noninvasive results. Breath testing protocols require standardization; for instance, the addition of a test meal may not be necessary in older children. Although noninvasive tests for the presence ofH pyloriin children may provide accurate results and can be considered for use in the initial assessment of dyspeptic children, further work is required to establish the most accurate testing methods.

scholarly journals Serology Is More Sensitive Than Urea Breath Test or Stool Antigen for the Initial Diagnosis of Helicobacter pylori Gastritis When Compared With Histopathology

2020 ◽  
Vol 154 (2) ◽  
pp. 255-265
Author(s):  
Dustin E Bosch ◽  
Niklas Krumm ◽  
Mark H Wener ◽  
Matthew M Yeh ◽  
Camtu D Truong ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Access To Care ◽  
Breath Test ◽  
Diagnostic Error ◽  
Urea Breath Test ◽  
Positive Serology ◽  
Noninvasive Test ◽  
Stool Antigen ◽  
And Performance ◽  
H Pylori

Abstract Objectives To assess the concordance and performance characteristics of Helicobacter pylori laboratory tests compared with histopathology and to propose algorithms for the diagnosis of H pylori that minimize diagnostic error. Methods H pylori diagnostics were reviewed from a 12-year period within a health system (2,560 cases). Analyses were performed to adjust diagnostic performance based on treatment and consensus histopathologic diagnoses among pathologists. Markers of access to care, including test cancellation frequency and turnaround time, were assessed. Costs and performance of candidate noninvasive testing algorithms were modeled as a function of disease prevalence. Results Serum H pylori IgG demonstrated a higher sensitivity (0.94) than urea breath and stool antigen tests (0.64 and 0.61, respectively). Evidence of an advantage in access to care for serology included a lower cancellation rate. Interobserver variability was higher (κ = 0.34) among pathologists for cases with a discordant laboratory test than concordant cases (κ = 0.56). A model testing algorithm utilizing serology for first-time diagnoses minimizes diagnostic error. Conclusions Although H pylori serology has modestly lower specificity than other noninvasive tests, the superior sensitivity and negative predictive value in our population support its use as a noninvasive test to rule out H pylori infection. Reflexive testing with positive serology followed by either stool antigen or urea breath test may optimize diagnostic accuracy in low-prevalence populations.

scholarly journals Clinical Validation of an Office-Based14C-UBT (Heliprobe) forH. pyloriDiagnosis in Iranian Dyspeptic Patients

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Fariborz Mansour-Ghanaei ◽  
Omid Sanaei ◽  
Farahnaz Joukar
Keyword(s):  
Predictive Value ◽  
Gold Standard ◽  
Urea Breath Test ◽  
Diagnostic Methods ◽  
Rapid Urease Test ◽  
Clinical Validation ◽  
Igg Antibodies ◽  
Urease Test ◽  
Gastric Biopsies ◽  
H Pylori

Background. We encountered repeatedly, in our clinical practice, discordant results between UBT and histopathology aboutH. pyloriinfection.Goal. To study the diagnostic accuracy of Heliprobe14C-urea breath test (14C-UBT) for detection ofH. pyloriinfection in an Iranian population.Study. We enrolled 125 dyspeptic patients in our study. All of them underwent gastroscopy, and four gastric biopsies (three from the antrum and one from the corpus) were obtained. One of the antral biopsies was utilized for a rapid urease test (RUT), and three others were evaluated under microscopic examination. Sera from all patients were investigated for the presence ofH. pyloriIgG antibodies. The14C-UBT was performed on all subjects using Heliprobe kit, and results were analyzed against the following gold standard (GS):H. pyloriinfection considered positive when any two of three diagnostic methods (histopathology, RUT, serology) are positive.Results. According to data analysis, the Heliprobe14C-UBT had 94% sensitivity, 100% specificity, 93% negative predictive value (NPV), 100% positive predictive value (PPV), and 97% accuracy, compared with GS.Conclusion. The Heliprobe14C-UBT is an easy-to-perform, rapid-response, and accurate test forH. pyloridiagnosis, suitable for office use.

scholarly journals Comparison of Helicobacter Pylori Genotypes Obtained from the Oropharynx and Stomach of the Same Individuals – A Pilot Study

2012 ◽  
Vol 113 (3) ◽  
pp. 231-239 ◽  
Author(s):  
Petr Lukeš ◽  
E. Pavlík ◽  
B. Potužníková ◽  
J. Plzák ◽  
E. Nártová ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Breath Test ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Urea Breath Test ◽  
Pcr Analysis ◽  
Realtime Pcr ◽  
Oropharyngeal Infection ◽  
Gastric Biopsies ◽  
H Pylori

Helicobacter pylorihas been recently detected in the oral cavity and oropharynx. However, the role it plays in oral and oropharyngeal pathogenesis remains unclear. The virulence ofH. pyloristrains can be distinguished according to the virulence factors genes carried. Our research has been focused on realtime PCR analysis ofcagAandvacAgenes ofH. pyloristrains in tonsils and tonsillar squamous cell cancer and their comparison withH. pyloristrains obtained from the gastric mucosa of the same patients. Urea breath test (UBT) test was used to detect a gastricH. pyloriinfection in 20 patients with previously provenH. pyloriin the oropharynx. Genotyping ofH. pyloriin gastric biopsies was performed in patients with positive gastric infection. Out of 20 patients positive for oropharyngealH. pylori, 8 were positive for concurrent gastricH. pyloriinfection. In 6 of them gastric biopsies were obtained. Comparison of oropharyngeal and stomachH. pylorigenotypes showed important differences. Four of 6 patients had differentH. pyloristrains in the oropharynx and stomach. The differences were found incagAgene as well as invacAgene. The finding of oral presence ofH. pyloriwithout concurrent stomach infection was confirmed using UBT. The results show that more than oneH. pyloristrain can be present in oropharynx and stomach in the same patient. The oropharyngeal infection seems to be independent to the gastric infection.

scholarly journals Increased Resistance of Fluoroquinolones among H. pylori isolates from Patients with Gastroduodenal Diseases in Jordan

2020 ◽  
Vol 17 ◽  
Keyword(s):  
Antimicrobial Agents ◽  
Culture Media ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Strains ◽  
Chronic Active Gastritis ◽  
Gastric Biopsies ◽  
Stool Antigen ◽  
H Pylori ◽  
Emergence Of Resistance

Recently, Helicobacter pylori has been connected to more than 80% of chronic active gastritis and other gastroduodenal diseases worldwide. Treatment of H. pylori is routinely dependent on the use of multiple antimicrobial agents however, recent data showed the emergence of resistance among clinical strains especially against metronidazole and clarithromycin. This study was conducted to investigate the rate of resistance to different antibiotics that are routinely used in the first line and second line therapies including ciprofloxacin and levofloxacin, tetracycline, amoxicillin, clarithromycin and metronidazole among H. pylori strains isolated from patients with gastroduodenal diseases in Jordan. Both antral and corpus mucosal biopsies from the stomach of patients with positive results of H. pylori stool antigen and urease breath tests were used for the isolation of H. pylori on selective culture media. The standard agar diffusion method was performed to determine the sensitivity of H. pylori clinical isolates against ciprofloxacin and levofloxacin according to CLSI. Among 62 H. pylori clinical strains isolated from gastric biopsies, 21% and 11% were resistant to levofloxacin and ciprofloxacin respectively. Resistance to metronidazole and clarithromycin was found in 90% and 11% respectively. No resistance was observed against amoxicillin, tetracycline and gemifloxacin. The following MIC90 (mg/L) of resistant strains results were obtained at neutral pH 7.3, 64 for metronidazole, 2 for clarithromycin, 2 for ciprofloxacin and 1 for levofloxacin. The present study reported the emergence of increased resistance of fluoroquinolones among H. pylori clinical isolates in Jordan. Concern should be taken into consideration when triple and quadruple therapy regimens are applied for the management of H. pylori infections in our region

scholarly journals The Use of 13C-Urea Breath Test for Non-Invasive Diagnosis of Helicobacter pylori Infection in Comparison to Endoscopy and Stool Antigen Test

Diagnostics ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 448
Author(s):  
Hamed Alzoubi ◽  
Asma’a Al-Mnayyis ◽  
Ibrahim Al rfoa ◽  
Amin Aqel ◽  
Mohammad Abu-Lubad ◽  
...  
Keyword(s):  
Breath Test ◽  
Eradication Therapy ◽  
Urea Breath Test ◽  
P Value ◽  
Antigen Test ◽  
Stool Antigen Test ◽  
Non Invasive ◽  
Stool Antigen ◽  
13C Urea Breath Test ◽  
H Pylori

Helicobacter pylori (H. pylori) can cause gastritis, peptic ulcer diseases and gastric carcinoma. Endoscopy as the gold standard method of diagnosis is an invasive procedure that might not be suitable in all scenarios. Therefore, this first study in Jordan aimed to assess the non-invasive 13C urea breath test (UBT) and stool antigen test for diagnosis of H. pylori infection and the successfulness of eradication therapy as alternatives for endoscopy. Hence, a total of 30 patients attending the endoscopy units at Alkarak teaching hospital were asked to complete a questionnaire with demographic and clinical data. They were then tested for H. pylori using 13C UBT and H. pylori stool antigen before having endoscopy. Another 30 patients who were positive for H. pylori by endoscopy were tested using both tests 6 weeks post eradication therapy. Results showed that the rate of H. pylori detection using endoscopy was 56.7% (17/30). Heartburns (82.3%, p value = 0.019), epigastric pain (88.2%, p value = 0.007) and vomiting (70.5%, p value = 0.02) were the most significant symptoms. Family history of peptic ulcer diseases was significantly associated with an increased risk for having a H. pylori positive result (p value = 0.02). Compared to endoscopy, the sensitivity of 13C UBT for the diagnosis of H. pylori was 94.1% (16/17), while it was 76.5% (13/17) for the stool antigen test. The specificity of both tests was equal (76.9%). However, the positive predictive and negative predictive values (84.2% and 90.9%) for 13C UBT were higher than those (81.3% and 71.4%) for the stool antigen test. The accuracy of 13C UBT was 86.7% compared to 76.7% for the stool antigen test. There was an 87% agreement (20 patients out of 23) between both tests when used to assess success of the eradication therapy. In conclusion, the 13C UBT was found to be more sensitive and accurate than the stool antigen test when used for diagnosis; furthermore, it has a comparable outcome to the stool antigen test in assessing the successfulness of the eradication treatment.

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

2013 ◽  
Vol 51 (11) ◽  
pp. 3735-3740 ◽  
Author(s):  
Dulciene Maria Magalhães Queiroz ◽  
Mayuko Saito ◽  
Gifone Aguiar Rocha ◽  
Andreia Maria Camargos Rocha ◽  
Fabrício Freire Melo ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
South America ◽  
Breath Test ◽  
Urea Breath Test ◽  
Infants And Toddlers ◽  
Antigen Test ◽  
Stool Antigen Test ◽  
Stool Antigen ◽  
13C Urea Breath Test ◽  
H Pylori

scholarly journals Audit ofHelicobacter pyloriTesting in Microbiology Laboratories in England: To Inform Compliance with NICE Guidance and the Feasibility of Routine Antimicrobial Resistance Surveillance

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Rosalie Allison ◽  
Donna M. Lecky ◽  
Megan Bull ◽  
Kim Turner ◽  
Gauri Godbole ◽  
...  
Keyword(s):  
Susceptibility Testing ◽  
Clinical Excellence ◽  
Breath Tests ◽  
Noninvasive Test ◽  
Stool Antigen Test ◽  
Nice Guidance ◽  
Gastric Biopsies ◽  
Stool Antigen ◽  
Stool Specimens ◽  
H Pylori

Introduction. The National Institute for Health and Clinical Excellence (NICE) guidance recommends that dyspeptic patients are tested forHelicobacter pyloriusing a urea breath test, stool antigen test, or serology. Antibiotic resistance inH. pyloriis globally increasing, but treatment in England is rarely guided by susceptibility testing or surveillance.Aims. To determine compliance of microbiology laboratories in England with NICE guidance and whether laboratories perform culture and antibiotic susceptibility testing (AST).Methods. In 2015, 170 accredited English microbiology laboratories were surveyed, by email.Results. 121/170 (71%) laboratories responded; 96% providedH. pyloritesting (78% on site). 94% providedH. pyloridiagnosis using stool antigen; only four provided serology as their noninvasive test; 3/4 of these encouraged urea breath tests in their acute trusts. Only 22/94 (23%) of the laboratories performedH. pyloricultures from gastric biopsies on site; 9/22 performed AST, but the vast majority processed less than one specimen/week.Conclusions. Only five laboratories in England do not comply with NICE guidance; these will need the guidance reinforced. National surveillance needs to be implemented; culture-based AST would need to be centralised. Moving forward, detection of resistance inH. pylorifrom stool specimens using molecular methods (PCR) needs to be explored.

scholarly journals Frequency of helicobacter pylori stool antigen in individuals with dyspeptic symptom

2019 ◽  
Vol 26 (06) ◽  
Author(s):  
Khalid Ahmed Tareen ◽  
Riaz Hussain Awan ◽  
Seema Nayab ◽  
Khadim Hussain Awan ◽  
Faqir Muhammad Awan
Keyword(s):  
Eradication Therapy ◽  
Cross Sectional Study ◽  
Dyspeptic Symptom ◽  
National Hospital ◽  
Cross Sectional ◽  
Dyspeptic Symptoms ◽  
Stool Antigen ◽  
The Mean ◽  
H Pylori ◽  
Study Setting

Objectives: To evaluate the frequency of H. pylori stool antigen in individuals with dyspepsia. Study Design: Cross sectional study. Setting: Liaquat National Hospital, Karachi. Period: July-2017 to 31st December-2017). Patients and Methods: The individuals with dyspeptic symptoms for ≥3 months durations were included and explored for H. Pylori infection by H. Pylori stool antigen while the result were analyzed and frequencies and percentages were calculated. Results: The mean ± SD for overall population was 36.29±8.57 years while the frequency of H. pylori was recorded as 38.57% (54/140) patients respectively. Conclusion: H. pylori infection usually observed in dyspeptic individuals and should be screened for eradication therapy.

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