Current Standards in the Diagnosis of &lt;i&gt;Helicobacter pylori&lt;/i&gt; Infection

Leodolter, Andreas; Wolle, K.; Malfertheiner, Peter

doi:10.1159/000050665

Cited by 33 publications

(20 citation statements)

References 41 publications

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“…Bacteriological culture and histology allow only the semi-quantitative determination of infection, and both require experienced professionals for their execution and the interpretation of results (Christensen et al, 1992;Atherton et al, 1996;El-Zimaity et al, 1996;Leodolter et al, 2001). On the other hand, the RT-PCR assay can accurately detect and quantify five bacterial cells per 200 ng of human DNA as previously described (Mikula et al, 2003;SchabereiterGurtner et al, 2004).…”

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confidence: 99%

“…Although it has been shown that the detection sensitivity of "gold standard" methods for H. pylori is highly reduced when the density of H. pylori is low and their distribution is "patchy" (Leodolter et al, 2001;Vaira et al, 2002) our results indicated that biopsies from all the patients considered to be negative had an H. pylori density higher than 10000 cells, as previously reported by He et al (2002). Growing evidence supports the concept that H. pylori exists in two viable forms, spiral or coccoid, and several studies have shown that the coccoid form cannot be cultured or be detected by RUT or histology but can be detected PCR (Bode et al, 1993;Chan et al, 1994;Hulten et al, 1996;Moayyedi and Dixon, 1998;He et al, 2002).…”

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confidence: 99%

“…Several studies have shown that the eradication of H. pylori plays an important role in the treatment of some gastrointestinal diseases (Tytgat, 1994) and the results of all currently used tests for bacterial detection can be affected by the treatment (Leodolter et al, 2001;Vaira et al, 2002).…”

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Quantitative real-time PCR for the clinical detection of Helicobacter pylori

et al. 2007

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Accurate diagnosis of Helicobacter pylori infection is very important in both clinical practice and research. We evaluated the sensitivity of real-time PCR (RT-PCR) for the detection and quantification of Helicobacter pylori using DNA from 91 human gastric biopsy samples divided into three groups: 46 biopsies from untreated patients who according to the references methods were considered H. pylori-negative (group A); 35 biopsies from patients previously treated against H. pylori and considered to be cured by "gold standard" tests (group B); and 10 biopsies from patients H. pylori-positive by all available methods (group C). The sensitivity of the RT-PCR assay was higher than that of standard methods. Of the 81 patients considered to be uninfected according to the references methods, 16 were H. pylori-positive by PCR, 10 of which were patients who had received H. pylori eradication therapy and 6 were untreated patients. Based on these findings we recommend that RT-PCR should be use in addition to standard methods in clinical studies to monitor the results of H. pylori eradication therapy.

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Quantitative real-time PCR for the clinical detection of Helicobacter pylori

et al. 2007

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“…The sensitivities and specificities of the commercial H. pylori antibody tests seemed to vary between 60 and 100% (3,12). The accuracy of serological tests is strongly dependent on the prevalence of H. pylori infection (13,17). Although it has been recommended that antibody assays be evaluated locally (4,13), this has rarely been carried out for different age groups.…”

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“…The accuracy of serological tests is strongly dependent on the prevalence of H. pylori infection (13,17). Although it has been recommended that antibody assays be evaluated locally (4,13), this has rarely been carried out for different age groups. Our results of the accuracy of the H. pylori IgG and IgA tests were superior to those reported earlier (3,11,12,24).…”

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Age-Dependent Accuracy of Helicobacter pylori Antibody Assays for Adults, with Special Emphasis on Atrophic Gastritis

Salomaa-Räsänen

Kosunen

Mattila

et al. 2004

Clin Vaccine Immunol

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The accuracy of Helicobacter pylori antibody assays for 561 consecutive adult outpatients who had undergone gastroscopy was studied. The sensitivity of an immunoglobulin G test was 99 to 100% for all age groups, but the specificity declined by age group, from 99% for those aged 15 to 49 years to 75% for those aged >65 years. The exclusion of false-positive results for patients with atrophic gastritis improved the specificity to 93 to 97% for the older age groups.Helicobacter pylori infection is associated with gastritis, peptic ulcer disease, and gastric malignancies (1). In about onethird or up to one-half of those infected with H. pylori, gastritis proceeds to atrophic gastritis, resulting in a loss of mucosal glands, decreased helicobacter colonization and, when affecting the corpus mucosa, decreased secretion of pepsinogen I (PGI) (10, 23).Most helicobacter-infected subjects have specific circulating immunoglobulin G (IgG) antibodies. However, IgA antibodies are found in approximately two-thirds of infected subjects (9). Of infected individuals, 2 to 7% show an elevated level of IgA antibody only (5, 9). Patients with atrophic corpus gastritis often have positive helicobacter serology, although microscopic examination (6, 22), culture of biopsy samples, and even the urea breath test remain helicobacter negative (8). These particular patients may still be infected, as shown by rapidly falling antibody titers after therapy (7).Enzyme immunoassay (EIA) is the most commonly used serological method for detecting antibodies to H. pylori. The best commercial kits have shown sensitivities and specificities of 90% to in excess of 95% (3, 12 Biopsy samples. Gastroscopies were performed by one of the authors (A.S.-R.) in a routine manner, with two biopsies from the gastric antrum (2 cm or more from the pylorus), two biopsies from the large curve of the gastric corpus for histological examination, and additional biopsies (one from the antrum and one from the corpus) for culture.Formalin-fixed biopsy specimens were embedded in paraffin. Tissue sections of 3 m were cut at three levels per biopsy and placed on one slide. The tissue sections were stained with hematoxylin and eosin, Alcian blue (pH 2.5)-periodic acidSchiff, and modified Giemsa. Gastritis was classified according to the Sydney System, in a blinded fashion, by one pathologist (J.M.) (20).The biopsies were mailed for culture in Transpocult tubes (Orion Diagnostica, Espoo, Finland). The specimens were cultured for H. pylori for up to 12 days on Brucella agar plates (Becton Dickinson, Sparks, Md.) (18) supplemented with whole horse blood (7%) and on selective Brucella agar plates containing Iso-Vitalex (1%), vancomycin (6 mg/liter), amphotericin B (2 mg/liter), and nalidixic acid (20 mg/liter).Results were considered helicobacter positive if culture or histology or both were positive.Serum tests. Serum samples were taken during each patient's visit to the endoscopic unit and were stored at Ϫ20°C until analyzed. Sera were tested for H. pylori IgG and IgA antibodie...

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Helicobacter

Owen¹

2010

Topley &Amp; Wilson's Microbiology and Microbial Infections

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Current Standards in the Diagnosis of <i>Helicobacter pylori</i> Infection

Cited by 33 publications

References 41 publications

Quantitative real-time PCR for the clinical detection of Helicobacter pylori

Quantitative real-time PCR for the clinical detection of Helicobacter pylori

Age-Dependent Accuracy of Helicobacter pylori Antibody Assays for Adults, with Special Emphasis on Atrophic Gastritis

Helicobacter

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