Efficacy of Different Laboratory Tests to Diagnose Helicobacter pylori Infection

Abstract

Helicobacter pylori is a Gram negative bacteria which causes chronic gastritis, peptic ulcer disease, primary B-cell gastric lymphoma, and adenocarcinoma of the stomach. There are a set of laboratory tests to diagnose H. pylori infection with a variable accuracy, they are divided into non-invasive tests and invasive tests. Non-invasive tests include serology, urea breath test (UBT) and stool antigen test (SAT). Invasive tests include rapid urease test (RUT), histology and culture. This cross sectional study was carried out in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and H. pylori laboratory of International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) from July 2008 to September 2009 to evaluate the efficacy of RUT, SAT and Culture as a diagnostic tool for H. pylori. Dyspeptic patients were collected from outpatient department of BSMMU. Out of 224 dyspeptic patients 149 patients had ulcers or erosions in the stomach or duodenum. Stool sample could be collected from 139 patients. RUT has sensitivity of 100%, specificity 80.28%, positive predictive value 85% and negative predictive value 100%. Regarding culture, sensitivity is 100%, specificity 94.37%, positive predictive value 95% and negative predictive value 100%. Stool antigen test has sensitivity 95.94%, specificity 92.31%,positive predictive value 93% and negative predictive value 95%. DOI: http://dx.doi.org/10.3329/fmcj.v8i1.16890 Faridpur Med. Coll. J. 2013;8(1): 11-14

<p>Observation of Changes in <em>Helicobacter pylori</em> Antigen and Antibody Positivity According to Non-Invasive Tests Before and After <em>Helicobacter pylori</em> Eradication Therapy in Symptomatic Patients</p>

“…This result is very similar to that of another study performed in Bangladesh, which showed a sensitivity of 95.9%, a specificity of 92.3%, a PPV of 93% and an NPV of 95% for the stool antigen test and is in consistency with some newer studies. [27][28][29] So the current study shows that HpSA test can be a reliable tool for diagnosis of H. pylori infection.…”

“…26 The detection of antigens in the stool by ELISA has shown in various studies to be an effective diagnostic test owing to its high specificity and sensitivity seen in various studies. [27][28][29] In infected individuals, H. pylori sticks to the gastric epithelial wall and is excreted in the feces, thus is a direct test of initial infection and is in superiority of serologic tests. 30 The stool antigen (HpSA) test is simple, rapid, reliable, non-invasive, hazard free and comparatively inexpensive.…”

Helicobacter Pylori Infection among Patients Attending the Gastroenterology Department in Tertiary Care Hospital, Kathmandu, Nepal

“…The relative risk of gastric cancer in an H. pylori -positive group is 1.7–5.3 times higher than that in an H. pylori -negative group [ 8 ]. However, only 10%–20% of infected patients develop severe diseases during their lifetime [ 9 ]. In the global population, approximately 50% of infected H. pylori varied by prevalence, age, country, ethnic background, and socioeconomic condition.…”

Is There Decreasing Prevalence of Helicobacter Pylori Infection in Patients with Dyspepsia?

“…Among 790 subjects, 768(97.2%) used to take PPI and among them 298(38.8%) was positive for stool antigen (Table I 16 In a hospital-based study stool antigen positivity rate was 51% in 2008-2009 among dyspeptic patients. 23 In our hospital-based study stool antigen positivity for H. pylori is 38.5% among dyspeptic patient. By RUT, H.pylori infection rates in dyspeptic patients were 78% in 2012-2013 and 43.6% in 2015.…”