Diagnosis of Helicobacter pylori infection

Abstract

Numerous studies are still published on diagnostic tests for Helicobacter pylori, essentially for noninvasive tests. The urea breath test is applied in different types of patients, and there are attempts to have quicker and simpler protocols. Stool tests using monoclonal antibodies are now evaluated while serology is still a subject of interest. The progress in PCR (multiplex PCR, real-time PCR) has also stimulated the research in this area of invasive tests, in order to get insight into virulence factors, macrolide susceptibility and to detect H. pylori in nonconventional specimens.

Increased Rate of Helicobacter pylori Infection Detected by PCR in Biopsies With Chronic Gastritis

“…10,20,25 Additional, noninvasive tests, including serology and stool antigen detection, may support the PCR findings. 38 Although sporadic carryover can never be completely excluded, a number of additional findings corroborate the accuracy of our assays, including the detection of H. pylori: DNA in other biopsies of the same patient (6 of 15 samples), an inflammatory score of .3 in 13 of 15 samples, and the presence of peptic ulcer diseases (9 of 15 samples), or a combination thereof ( Table 2). Although our study does not really define a gold standard, considering the PCR assay as gold standard, a sensitivity of 78.3% (confidence interval, 66.7-87.3) and a negative predictive value of 79.2 (confidence interval, 68.0-87.9) can be calculated for the detection of H. pylori by conventional histology (Table 1).…”

Comparison of the non-invasive diagnostic methods, stool antigen test and PCR assay, for Helicobacter felis detection in dogs

“…However, PCR analysis also has been reported several limitations (Kim et al, 2006). There is no single gold standard among the diagnostic tests for Helicobacter infection but all of the tests have their pitfalls and limitations (Rautelin et al, 2003). Among noninvasive methods, stool specimens are easy to obtain and consequently of high potential interest for the development of a direct method of Helicobacter species detection (Kim et al, 2006;Lee et al, 2007).…”

Point-of-care Helicobacter pylori urine antibody detection in a multi-ethnic adult population in the United States

“…Antibody tests have another advantage over tests that require the presence of a large bacterial load, such as the stool antigen test, UBT, culture, and histology, as antibody tests do not share the problem of false-negative results with the stool antigen test, UBT, culture, and histology, which are often falsely negative when patients are receiving medications that reduce the bacterial load, such as proton-pump inhibitors, bismuth, or antibiotics. 18,19 As the urine antibody test assesses the presence of anti-H. pylori IgG antibody, it is not influenced by any of these factors. 45 However, because the urine antibody test theoretically has the same limitations as serologic tests, including detection of residual specific IgG antibody long after an infection has been eradicated, it is not yet clear how long one must wait before test will become negative after H. pylori eradication.…”

“…Although some exceptions exist, the sensitivity and specificity of most serologic tests are relatively low. [17][18][19][20][21][22][23][24][25] Anti-H. pylori IgG is also detectable in the urine of H. pylori-infected patients and has been successfully used for the diagnosis of H. pylori infections and was the basis for the point-of-care device tested in this study. 26 -34 In the United States, the burden of H. pylori disease is concentrated in ethnic minorities such that diagnostic testing is currently focused on those patients.…”