Evaluation of the String Test in Intestinal Bacterial Overgrowth

Liebman, William M.; Rosenthal, Philip

doi:10.1001/archpedi.1983.02140380037012

Cited by 6 publications

(5 citation statements)

References 7 publications

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“…To our knowledge this is the first formal evaluation of the tolerability and acceptability of any procedure for retrieval of respiratory specimens from children and of the use of the string test (for any reason) in children. Our findings are consistent with previous anecdotal reports [ 16 , 17 , 20 ].…”

Section: Discussionsupporting

confidence: 94%

La cuerda dulce – a tolerability and acceptability study of a novel approach to specimen collection for diagnosis of paediatric pulmonary tuberculosis

et al. 2006

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BackgroundRecent data demonstrate the utility of the string test for the diagnosis of sputum-scarce HIV-associated TB in adults. We hypothesized that, if well-tolerated by children, this simple tool might offer a breakthrough in paediatric TB diagnosis. Thus the objective of this study, undertaken in the paediatric service of the Hospital Nacional Dos de Mayo, Lima, Perú, was to determine the tolerability and acceptability of the string test to paediatric TB suspects, their parents and nursing staff.Methods22 paediatric subjects aged 3–14 years (median 8) under investigation for TB were invited to undergo 2 string tests (four-hour downtime each). Subjective and objective pain and discomfort rating scales were used to assess the perception of the subject, parent and attending nurse.ResultsPatients as young as 4 years tolerated the procedure extremely well with 84% willing to undergo a second procedure. Peak discomfort at the time of swallowing and of string retrieval was mild (30% of maximum possible score) and brief as judged by visual analogue ratings and objective indicators. Good concordance of parent/child and objective/subjective ratings strengthened the validity of these findings.ConclusionThe string test is well tolerated and achievable for most paediatric TB suspects as young as 4 years. A formal prospective paediatric efficacy study is now needed.

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Section: Discussionsupporting

confidence: 94%

La cuerda dulce – a tolerability and acceptability study of a novel approach to specimen collection for diagnosis of paediatric pulmonary tuberculosis

et al. 2006

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“…The string test has been used successfully to diagnose SBBO in hospitalized children (12,16,17), but has not yet been used in field based studies. There was no indication that the lactulose solution given in conjunction with the string test nor the sterilized water given with the string test to aid in its swallowing harbored bacteria (e.g., cloudiness, unusual taste).…”

Section: Discussionmentioning

confidence: 99%

“…The test was done at the same time as the lactulose BHT , the string being swallowed by the child 30 min after the start of the BHT. The string was left for 4 h before withdrawal (11,12) to allow the string to pass into the small intestine to its fullest extent. The child was instructed to stand with head tilted back while the string was withdrawn gently and quickly.…”

Section: Isolation and Culture Of Upper Smallmentioning

confidence: 99%

In Vitro Hydrogen Production by Enteric Bacteria Cultured from Children with Small Bowel Bacterial Overgrowth

Khin‐Maung‐U,

Tin‐Aye,

Ku‐Tin‐Myint

et al. 1992

J. pediatr. gastroenterol. nutr.

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SummaryLactulose breath hydrogen test and Enterotest string test were carried out simultaneously on 19 children 3–5 years old. Bacteria isolated from the jejunal fluid in upper small intestines of these children were incubated with lactulose at neutral pH. Anaerobes were present in all but one child, and in 15 children they were present in numbers greater than 5 log10 organisms per ml. Most of these bacteria did not produce hydrogen in vitro. Hydrogen production (>100 ppm) was observed with the following bacteria: Bacteroides (5%), Clostridia (8%), anaerobic corynebacteria (5%), Escherichia coli (67%), Lactobacillus (8%), Staphylococcus (8%), and Streptococcus (9%). The following bacteria did not produce hydrogen in vitro: Actinobacter, Actinomyces, anaerobic cocci, Bifidobacterium, Fusobacterium, micrococci, Neisseria, Sarcina, and Veillonella. This study suggests that in the diagnosis of small bowel bacterial overgrowth using lactulose breath hydrogen test, it is important to consider that patients with a flat breath hydrogen response to a carbohydrate challenge during the first 60 min may be infected with enteric bacteria which are not capable of producing H2.

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“…Die Messung des stabilen Isotopes 13 CO 2 in der Ausatemluft verspricht nach dem gegenwä rtigen Stand eine hö here Spezifitä t und Sensitivitä t als die bisherigen Verfahren [1,6,7], abgesehen von den aufwendigen Methoden eines Direktnachweises einer bakteriellen Dü nndarmü berwucherung [4,9]. Eine Belastung durch Radioaktivitä t besteht bei 13 CO 2 -Atemtests nicht.…”

Section: Diskussionunclassified