Diagnosis of Helicobacter pylori infection: faecal antigen determination

Vaira, Dolores; Ricci, Chiara; Menegatti, Marcello; Acciardi, Carmela; Gatta, Luigi; Geminiani, A; Miglioli, M.

doi:10.1007/978-94-011-3927-4_12

Cited by 3 publications

(5 citation statements)

References 20 publications

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“…In fact, some authors have demonstrated that stool antigen testing showed good sensitivity and specificity even with frozen stool samples stored for up to 225 days [94]. This makes it possible to collect multiple samples over several days or weeks, allowing testing of several samples in one session, thus reducing costs; this is of particular benefit in a small hospital with few patients [9]. Moreover, it is possible to store samples, which could be employed in future analysis [9].…”

Section: Resultsmentioning

confidence: 99%

“…This makes it possible to collect multiple samples over several days or weeks, allowing testing of several samples in one session, thus reducing costs; this is of particular benefit in a small hospital with few patients [9]. Moreover, it is possible to store samples, which could be employed in future analysis [9]. Some authors have evaluated the accuracy of the stool antigen test in general practice using a regular postal service without cooling of the specimens [59].…”

Section: Resultsmentioning

confidence: 99%

“…However, attempts to isolate H. pylori from human stool samples have shown that viable organisms are present in only a small percentage of cases [4–7]. Nevertheless, despite the difficulties encountered in stool culture, the extensive indirect evidence suggesting that the organism, or parts of it, can be found in faeces (for example by PCR [8]) raised the possibility of developing a noninvasive diagnostic test based on the detection of bacterial antigen in stool [9–11].…”

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confidence: 99%

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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%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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

Gisbert¹,

Jm²

2004

Helicobacter

185

140

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“…Such methods would have the advantages of easy obtainment of samples, a short collection time, and no need for fasting, would detect active infection, and would not depend on the examiner's previous experience. Recently, an enzyme immunoassay (Premier Platinum H. pylori stool antigen [HpSA] test; Meridian Diagnostics, Italy) developed with rabbit polyclonal anti-H. pylori capture antibodies, specific for H. pylori, able to detect antigenic protein in feces at minimum concentrations of 184 ng/ml has shown a satisfatory accuracy in adult patients (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27).…”

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confidence: 99%

Evaluation of the Stool Antigen Test for Helicobacter pylori in Children and Adolescents

2005

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The stool antigen test for Helicobacter pylori is a noninvasive immunoassay to diagnose active infection with Helicobacter pylori in human fecal samples. Its performance in children and teenagers has been tested in some developed countries, showing a sensitivity and specificity above 90%, however, its accuracy in developing countries and in children under 6 years is not well established. To determine the accuracy of the test for diagnosing Helicobacter pylori infection in children and teenagers, we evaluated 133 patients (4 months to 17 years old). The gold standard was a positive culture or positive histology and rapid urease test. The test was done according to the manufacturer's instructions. However, modifications were introduced for better reproducibility. Samples were analyzed twice and results are expressed as optical density (OD) determined spectrophotometrically at 450 nm. HpSA was considered positive at OD > or =0.160 and negative at OD <0.140. One hundred twenty-seven of the 133 (95.5%) patients were included. There were no infected infants. The test showed a 94.6% sensitivity (95% CI: 90.6-98.5) and a 96.5% specificity (95% CI: 93.3-99.7). At ages 2 to 6 years the specificity was 96.4% (95% CI: 85.1-99.2) and the sensitivity was 80.0% (95% CI: 64.8-89.7), at ages 6 to 10 years the sensitivity was 100.0% and the specificity 95.7%, and above 10 years the sensitivity and specificity were 100.0%. We conclude that the test is efficient in adolescents and children, however there is a need for further studies with a greater number of patients for evaluation of its accuracy in infants.

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“…Although the sensitivity and specificity of invasive endoscopic techniques, especially for histologic examination, remain high, the sensitivity of endoscopy is affected by concomitant PPI therapy, sampling error, poor orientation and handling of specimens, and experience of the pathologist [39]. Moreover, the additional cost associated with procedure "up coding," combined with pathology and microbiology charges, do not make biopsy (even a biopsy urease test) a cost-effective means solely to diagnose H. pylori infection.…”

Section: Diagnosis Of H Pylori Infectionmentioning

confidence: 99%

Helicobacter pylori-associated diseases

Sanders

Peura

2002

Curr Gastroenterol Rep

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Since the initial report 20 years ago by Marshall and Warren of an unidentified curved bacillus located on the gastric epithelium of patients with chronic active gastritis, the discovery of Helicobacter pylori and its association with a number of gastrointestinal diseases has revolutionized the field of gastroenterology. Although the association of H. pylori infection with peptic ulcer disease, chronic gastritis, mucosa-associated lymphoid tissue lymphoma, and gastric adenocarcinoma has been well documented over the past two decades, other areas remain less clear, including the role of H. pylori in gastropathy associated with nonsteroidal anti-inflammatory drugs, gastroesophageal reflux disease, and both uninvestigated and nonulcer dyspepsia. Although these areas still remain somewhat controversial, recent reports further clarify the role of H. pylori in these conditions. A review of the recent literature regarding H. pylori-associated diseases is presented along with recommendations for diagnosis and treatment of H. pylori infection.

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Diagnosis of Helicobacter pylori infection: faecal antigen determination

Cited by 3 publications

References 20 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 the Stool Antigen Test for Helicobacter pylori in Children and Adolescents

Helicobacter pylori-associated diseases

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