Detection of Helicobacter Pylori infection by invasive and non-invasive techniques in patients with gastrointestinal diseases from Iraq: A validation study

Abstract

There is still no agreement on the gold standard technique for diagnosing of H. Pylori in Iraq, as well as a paucity of data on the validity of different diagnostic techniques. This study aimed to investigate the prevalence of this bacterium with different methods and compare them to the quantitative polymerase chain reaction (qPCR) as a golden standard technique among Iraqi patients. In total, 115 Iraqi patients strongly suspected of H. pylori infection were enrolled in the current study. Invasive techniques including rapid urease testing (RUT) and gastric tissue culture in addition to non-invasive techniques including 14C-Urea breath test (14C-UBT), stool antigen test (SAT), CagA-IgG serology, and qPCR were performed to confirm the H. pylori infection. The qPCR was used as the gold standard to estimate the sensitivity, specificity, positive and negative predictive values for the studied diagnostic tests. Overall, the prevalence rate of H. pylori in Iraqi patients was ranged from 47.8 to 70.4% using different methods. The positive results for each test were as follows: qPCR 81, (70.4%) UBT 79 (68.7%), SAT 77 (67%), RUT 76 (66.1%), Cag-IgG 61 (53%), and culture 55 (47.8%). The 14C-UBT showed the highest overall performance with 97.5% sensitivity, 97% specificity, and total accuracy of 97.3% followed by SAT, RUT, Cag-IgG, and culture method. Based on the accuracy of the studied methods for H. pylori detection, they can be arranged in order as follows: qPCR > UBT > SAT > RUT> CagA IgG > culture. Since a universal gold standard assay for the diagnosis of H. pylori has not yet been established in Iraq, the UBT may be recommended as first choice due to its higher performance compared to other methods.

Chinese Consensus Report on Family-Based Helicobacter pylori Infection Control and Management (2021 Edition)

“…Other invasive methods for H. pylori detection include rapid urease tests, 148–150 histological examination of gastric mucosal biopsies, 150 151 cultures 148 152 and molecular techniques. 139 140 These are available in various clinical settings, but they are inconvenient and require endoscopy to obtain biopsy samples.…”

Prevalence of bacterial vaginosis and aerobic vaginitis and their associated risk factors among pregnant women from northern Ethiopia: A cross-sectional study

“…In the current study, the frequency of multiple drug resistant isolates was higher (45.5%) than previous study by Tang et al [14] from China (13.4%). In recent years, the prevalence of infectious diseases and multiple drug resistant bacteria harboring different resistance genes has been increasing [82][83][84][85]. These issues highlight the need to develop a global monitoring program, especially for pregnant women, to reduce the risk of vaginal infection spreading among the mothers and infants and to control the antibiotic resistance phenomenon in different countries.…”

Detection of clarithromycin resistance and 23SrRNA point mutations in clinical isolates of Helicobacter pylori isolates: Phenotypic and molecular methods

“…Further, the results of an invasive rapid urease test (RUT) were found using a urea agar slant tube, RT-PCR amplification of 16srRNA using the thermal cycler (Sacace - Italy) with a RT-PCR kit for qualitative detection of H. pylori ((Sacace- Italy), UBT using a HUBT-20p H. pylori detector (HEADWAY, China) using 14 a C-urea, 99-atom% 14 C-labelled urea capsule. SAT was performed using the H. pylori Ag Rapid Test CE (CTK - Biotech, USA), whilst cagA-IgG was performed using a commercial Human H. Pylori Cytotoxin-Associated Gene A Protein IgG (HP-CagA-IgG) ELISA Kit (CUSABIO, USA) by ELISA system (Human, Germany) ( Hussein et al, 2021 ).…”