An Analysis of Seven Different Methods to Diagnose<i>Helicobacter pylori</i>Infections

Andersen, Lis Smedegaard; Kiilerick, S.; Pedersen, Guro M.; Thoreson, A.-C.E.; Jørgensen, F.; Rath, Jayasree; Larsen, Niels‐Erik; Børup, O.; Krogfelt, Karen A.; Scheibel, J.; Rune, S. J.

doi:10.1080/00365529850166167

Cited by 53 publications

(5 citation statements)

References 22 publications

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“…For 13 C-urea breath test, only 1 out of 10 Hp-positives would be lost. Regarding the serological test, the specificity in nonbleeders corresponds to previous reported values [7]. The discrepancy in specificity results in the difference in positive predictive values between groups 1 and 2.…”

Section: Discussionmentioning

confidence: 58%

“…The test is regarded positive when >200 EU (ELISA units). In a Danish study [7]of dyspeptic patients, the sensitivity end specificity of the test was 81 and 78% using positive culture or Hp seen in histologic sections as gold standard. In this study, patients were considered serology-positive when the ELISA test was >200 EU or a borderline value was confirmed by positive Western blotting.…”

Section: Methodsmentioning

confidence: 99%

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Diagnosis of Helicobacter pylori in Bleeding Peptic Ulcer Patients, Evaluation of Urea-Based Tests

Wildner-Christensen

Lassen²,

Lindebjerg³

et al. 2002

Digestion

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Background/Aims: The prevalence of Helicobacter pylori (Hp) has been reported to be lower in patients with bleeding peptic ulcers than in patients with nonbleeding peptic ulcers. This might be due to inaccuracy of the urease-based diagnostic tests when used in patients with bleeding peptic ulcers. The aims of this study were to compare the validity of the rapid urease test (RUT) and ¹³C-urea breath test in patients with bleeding (group 1) and nonbleeding peptic ulcers (group 2) and to examine whether the presence of blood in the stomach influences the validity of urease-based tests. Methods: 95 consecutive patients with bleeding peptic ulcers (48 with and 47 without blood in the stomach) and 44 with uncomplicated peptic ulcers. Biopsies for RUT and histology were obtained during endoscopy. After endoscopy a ¹³C-urea breath test was performed. Positive histology was used as ‘gold standard’ defining positive Hp-status. Results: The prevalence of Hp-infection was 44/95 (46%) in group 1 and 29/44 (66%) in group 2 (p = 0.04). The sensitivities and specificities of RUT, ¹³C-urea breath test and serology (control) were between 0.72 and 0.96; no difference was found between the groups. In group 1 the sensitivity of the RUT decreased from 0.96 when no blood was present to 0.60 when blood was present (p = 0.006). The sensitivity of ¹³C-urea breath test was not affected by blood in the stomach. Conclusion: When comparing patients with bleeding and nonbleeding peptic ulcers, we did not find any difference in either sensitivity or specificity of the diagnostic tests for Hp. However, the sensitivity of the RUT was lower when blood was present in the stomach, which was the case in only half of the patients. The sensitivity and specificity of the ¹³C-urea breath test was not affected by the presence of blood in the stomach.

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Section: Discussionmentioning

confidence: 58%

Section: Methodsmentioning

confidence: 99%

Diagnosis of Helicobacter pylori in Bleeding Peptic Ulcer Patients, Evaluation of Urea-Based Tests

Wildner-Christensen

Lassen²,

Lindebjerg³

et al. 2002

Digestion

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“…It is important to determine the best diagnostic method of HP infection, because it is possible that invasive test aggravates the ulcer bleeding in the emergent clinical state of peptic ulcer bleeding. Noninvasive tests have disputed that these are more useful than the invasive tests and more accurately reflect HP infection status 24 , 25 ) . High frequency of positive results in noninvasive tests ( 13 C-UBT and IgG serologic studies) was detected in our bleeding peptic ulcer patient in the first day, and UBT showed relatively high sensitivity at the seventh day.…”

Section: Discussionmentioning

confidence: 99%

What is the Best Method to Diagnose Helicobacter Infection in Bleeding Peptic Ulcers ? : A Prospective Trial

Chung

Hong

Kim

et al. 2001

Korean J Intern Med

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Background :It has been debated which diagnostic test should be preferred for the diagnosis of Helicobacter pylori (HP) in patients with peptic ulcer diseases. Several limitations are reported in bleeding peptic ulcers because of intragastric blood and possibility of changed numbers of organisms by medication. This study was designed to find out the best method for diagnosis of HP infection, in aspect of deciding the times of detection and the specific tests in bleeding peptic ulcers.Methods :We prospectively examined histology, rapid urease test (CLO test), urea breath test (13C-UBT) and serology in HP diagnostics in 32 patients with bleeding peptic ulcers to detect HP infection. Each test was performed two times (four methods at first 24 hours and former three methods at 7th day after initial therapeutic endoscopy). We evaluated the sensitivity of each test, compared the two-times results and evaluated the effect of these tests to an outcome of endoscopic hemostasis.Results :Diagnostic sensitivities of histology, CLO test, 13C-UBT and serology are 75%, 67.8%, 100% and 100% at first endoscopy, and 71.4%, 78.5%, 89.3% at 7th day endoscopy, respectively. Histologic study and CLO test had diagnostic limitation at emergent first endoscopy contrary to UBT (p<0.01). Histologic study, CLO test and UBT have limitations at 7th day endoscopy. Only 3 patients (9.4%) rebled with subsequent complete endoscopic hemostasis and all diagnostic tests at initial endoscopy did not influence the outcome of hemostasis.Conclusion :First day histologic and CLO tests are inadequate methods in detecting HP infection in patients with bleeding peptic ulcers. 7-day histologic, CLO test and UBT have a low sensitivity. First-day UBT can be a standard test to diagnose HP infection in patients with bleeding peptic ulcers.

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“…The two main noninvasive tools for the diagnosis of Hp infection are the 13 C-UBT and serologic tests. The breath test is easy to perform and generally has excellent sensitivity and specificity, very close to 100% [10, 11]. It can detect eradication of Hp 4 weeks after antibiotic therapy, when serological tests still give a positive result [12].…”

Section: Discussionmentioning

confidence: 99%

A New Simple Immunoassay for Detecting <i>Helicobacter pylori </i>Infection: Antigen in Stool Specimens

Fanti¹,

Mezzi²,

Cavallero³

et al. 1999

Digestion

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Background/Aim: Several diagnostic tests are available for evaluating Helicobacter pylori (Hp) infection: histological examination, culture of gastric biopsy specimens, rapid urease test, urea breath test and serology. A recently marketed direct enzyme immunoassay (HpSA) detects Hp antigen in stool samples. The aim of our study was to evaluate overall diagnostic sensitivity, specificity and positive and negative predictive values of this new diagnostic test. Methods: We included in the study 84 patients (39 males and 45 females; mean age 49.57 years) with dyspeptic symptoms who were examined by upper gastrointestinal endoscopy. Exclusion criteria were previous treatment with proton pump inhibitors, bismuth compounds or antibiotics. During the endoscopic examination biopsies were taken from antrum and corpus for Hp culture and histological examination, and stool specimens were submitted to the laboratory to be stored until the HpSA test. Hp was judged to be present when culture or histology and culture were positive. The ¹³C-urea breath test was done only in culture-negative patients in whom either histology or immunoassay or both were positive. Results: Hp was found in 55 patients by both culture and histology. Stool antigen has been detected in 54 of the 55 Hp-positive patients, giving a sensitivity of 98.2% and a negative predictive value of 96.4%. In 2 out of 29 patients HpSA gave a positive result, but the biopsy-based methods were negative, resulting in a low rate of false-positives, with 93.1% specificity and 96.4% positive predictive value; the ¹³C-urea breath test confirmed these results as negative. Conclusion: Our results show that this new test is highly sensitive and specific for the detection of Hp infection, and it is satisfactorily reproducible.

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An Analysis of Seven Different Methods to DiagnoseHelicobacter pyloriInfections

Cited by 53 publications

References 22 publications

Diagnosis of Helicobacter pylori in Bleeding Peptic Ulcer Patients, Evaluation of Urea-Based Tests

Diagnosis of Helicobacter pylori in Bleeding Peptic Ulcer Patients, Evaluation of Urea-Based Tests

What is the Best Method to Diagnose Helicobacter Infection in Bleeding Peptic Ulcers ? : A Prospective Trial

A New Simple Immunoassay for Detecting <i>Helicobacter pylori </i>Infection: Antigen in Stool Specimens

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