A novel near-patient test for the direct detection of H. pylori antigens in stool

Lakner, Meret; Leier, Sven; Dehnert, Sonja; Schwartz, Georg; Cullmann, G

doi:10.1016/s0016-5085(08)82437-7

Cited by 7 publications

(10 citation statements)

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“…Eighty‐nine studies, including 10,858 patients, fulfilled the inclusion criteria and evaluated the accuracy of the stool antigen test for the diagnosis of H. pylori in untreated patients (Table 1) [14–95]. Some of the studies reviewed included, in the same protocol, patients before and after therapy, without separating them depending on the time at which the H. pylori stool antigen test was performed, thus preventing us from calculating the true diagnostic accuracy in each circumstance [96–100].…”

Section: Resultsmentioning

confidence: 99%

Stool Antigen Test for the Diagnosis of Helicobacter pylori Infection: a Systematic Review

Gisbert¹,

Jm²

2004

Helicobacter

185

140

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Our aim was to review systematically the diagnostic accuracy of the Helicobacter pylori stool antigen test. Bibliographical searches were performed in several electronic databases and abstracts from congresses up to May 2003. Eighty-nine studies (10,858 patients) evaluated the stool antigen test in untreated patients. Mean sensitivity, specificity, positive predictive value and negative predictive value were 91%, 93%, 92% and 87%, respectively. Analysis of the eight studies (1399 patients) in which pretreatment evaluation of the monoclonal stool antigen test was performed showed better (p < .001) results (96%, 97%, 96% and 97%, respectively), with a clearer distinction between positive and negative results. Thirty-nine studies (3147 patients) evaluated the stool antigen test for the confirmation of H. pylori eradication 4-8 weeks after therapy, with accuracies of 86%, 92%, 76% and 93% for mean sensitivity, specificity, positive predictive value and negative predictive value, respectively. Results were similar when a gold standard based on at least two methods was used. Relatively low accuracy was reported in some posttreatment studies with the polyclonal stool antigen test. However, excellent results (p < .001) were achieved in all the six studies evaluating the monoclonal stool antigen test 4-8 weeks posttreatment. Results evaluating the stool antigen test < 4 weeks posttreatment are contradictory. Proton-pump inhibitors seem to affect the accuracy of the stool antigen test. Sensitivity and/or specificity in patients with gastrointestinal bleeding may be suboptimal. The stool antigen test performs well in children. Finally, the stool antigen test seems to be a cost-effective method.

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Section: Resultsmentioning

confidence: 99%

Stool Antigen Test for the Diagnosis of Helicobacter pylori Infection: a Systematic Review

Gisbert¹,

Jm²

2004

Helicobacter

185

140

View full text Add to dashboard Cite

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“…Finally, the ‘rapid’ immunochromatographic stool test is currently incorporated in a device which integrates sampling, processing and analysis in one test unit allowing for simple and hygienic handling. Although limited experience exists on this new method, encouraging results have been reported 2, 25–28 . As the results with this novel office‐test are available in approximately 5 min, it has the advantage of being suitable for the use at the doctor's office.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of three different tests for the detection of stool antigens to diagnose Helicobacter pylori infection in patients with upper gastrointestinal bleeding

Gisbert

Trapero

Calvet

et al. 2004

Aliment Pharmacol Ther

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SUMMARYAim: To evaluate the accuracy of several methods aimed to detect Helicobacter pylori stool antigens in patients with upper gastrointestinal bleeding. Methods: Thirty-four patients with upper gastrointestinal bleeding because of peptic ulcer were included. The first stool sample during hospitalization was collected, and stool antigens were determined with: polyclonal enzyme-linked immunosorbent assay (Premier-Platinum-HpSA); monoclonal enzyme-linked immunosorbent assay (Amplified-IDEIA-HpStAR); and rapid monoclonal immunochromatographic test (ImmunoCard-STAT HpSA). A patient was considered infected when H. pylori was diagnosed with invasive tests (rapid urease test or histology) or with 13 C-urea breath test.When all tests were negative, a new breath test was repeated after stopping proton pump inhibitors.

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“…These results contrast with the excellent values found with these tests in dyspeptic patients. 17,18,[22][23][24] The reasons for these different results between cirrhotics and dyspeptic patients remain unclear. Geographical variations in the H. pylori antigen pattern could account for the reduced reliability of the test in our area.…”

Section: Discussionmentioning

confidence: 99%

“…Excellent results have been reported with all these tests in dyspeptic patients. [15][16][17][18] However, these new stool antigen diagnostic tests have not been evaluated in patients with cirrhosis. Therefore, the objective of this study was to evaluate the reliability of these new stool antigen detection tests for the diagnosis of H. pylori infection in cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

“…13 In contrast, the 13 C-urea breath test is very sensitive and specific, but expensive, as it usually requires trained personnel to obtain the breath samples, and both 13 C-urea and the instrumentation necessary to interpret the samples are costly. 14 [15][16][17][18] However, these new stool antigen diagnostic tests have not been evaluated in patients with cirrhosis. Therefore, the objective of this study was to evaluate the reliability of these new stool antigen detection tests for the diagnosis of H. pylori infection in cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

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Stool antigen for the diagnosis of Helicobacter pylori infection in cirrhosis: comparative usefulness of three different methods

Calvet

Quesada

Roselló

et al. 2003

Aliment Pharmacol Ther

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Summary Background : Helicobacter pylori infection may lead to peptic ulcer disease, and causes significant morbidity in patients with cirrhosis. The measurement of H. pylori antigens in human stools has been proposed as a valuable, non‐invasive, diagnostic tool. A number of tests have recently been commercialized. However, very few data are available on their reliability in patients with cirrhosis. Aim : To evaluate the usefulness of three new tests — HpSA (Meridian Diagnostics Inc., Cincinnati, OH, USA), Simple H. pyl (OPERON S.A., Zaragoza, Spain) and FemtoLab H. pylori (Connex, Martinsried, Germany) — in the diagnosis of H. pylori infection in cirrhotic patients. Methods : H. pylori infection was determined in 79 cirrhotic patients (48 men, 31 women; age range, 29–82 years; mean, 62 ± 11 years) by concordance of histology and urea breath test. The sensitivity, specificity and positive and negative predictive values of each stool test were calculated. Results : According to the reference method, the sensitivities of HpSA, Simple H. pyl and FemtoLab H. pylori immunoassays were 76%, 87% and 78%, respectively, and their specificities were 93%, 62% and 79%, respectively. Conclusions : Faecal tests are non‐invasive and easy‐to‐perform tools for the diagnosis of H. pylori infection. However, their sensitivity and specificity seem to be non‐optimal in patients with cirrhosis.

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A novel near-patient test for the direct detection of H. pylori antigens in stool

Cited by 7 publications

References 0 publications

Stool Antigen Test for the Diagnosis of Helicobacter pylori Infection: a Systematic Review

Stool Antigen Test for the Diagnosis of Helicobacter pylori Infection: a Systematic Review

Evaluation of three different tests for the detection of stool antigens to diagnose Helicobacter pylori infection in patients with upper gastrointestinal bleeding

Stool antigen for the diagnosis of Helicobacter pylori infection in cirrhosis: comparative usefulness of three different methods

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