Human plasma is directly bacteriocidal against Helicobacter pylori in vitro, potentially explaining the decreased detection of Helicobacter pylori during acute upper GI bleeding

Houghton, JeanMarie; Ramamoorthy, Ravishankar; Pandya, Himanshu; Dhirmalani, Rajesh; Kim, Kyung H.

doi:10.1067/mge.2002.120391

Cited by 39 publications

(26 citation statements)

References 14 publications

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“…These data do not support the theory that the blood serum in the stomachs of bleeding patients has bactericidal activity against this microorganism and thus decreases the bacterial load (10). However, this theoretical decrease could also be attributed to the limited sensitivity of classical tests together with the fact that gastric lavage is carried out in these patients or that albumin is present in the stomach (27,28).…”

Section: Discussionmentioning

confidence: 74%

Real-Time PCR for Diagnosing Helicobacter pylori Infection in Patients with Upper Gastrointestinal Bleeding: Comparison with Other Classical Diagnostic Methods

et al. 2012

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The aim of this study was to determine the diagnostic usefulness of quantification of the H. pylori genome in detection of infection in patients with upper gastrointestinal bleeding (UGB). A total of 158 consecutive patients with digestive disorders, 80 of whom had clinical presentation of UGB, were studied. The number of microorganisms was quantified using a real-time PCR system which amplifies the urease gene with an internal control for eliminating the false negatives. A biopsy sample from the antrum and corpus of each patient was processed. The rapid urease test, culture, histological study, stool antigen test, and breath test were done. The gold standard was a positive culture or positive results in at least two of the other techniques. When a positive result was defined as any number of microorganisms/human cell, the sensitivity of real-time PCR was greater in bleeding patients, especially in the gastric corpus: 68.4% (95% confidence interval [CI], 52.3 to 84.5%) in non-UGB patients versus 91.5% (95% CI, 79.6 to 97.6%) in UGB patients. When a positive result was defined as a number of microorganisms/human cell above the optimal value that maximizes the Youden index (>3.56 microorganisms/human cell in the antrum and >2.69 in the corpus), the sensitivity and specificity in UGB patients were over 80% in both antrum and corpus. Our findings suggest that some bleeding patients with infection caused by H. pylori may not be correctly diagnosed by classical methods, and such patients could benefit from the improved diagnosis provided by real-time PCR. However, the clinical significance of a small number of microorganisms in patients with negative results in classical tests should be evaluated.

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Section: Discussionmentioning

confidence: 74%

Real-Time PCR for Diagnosing Helicobacter pylori Infection in Patients with Upper Gastrointestinal Bleeding: Comparison with Other Classical Diagnostic Methods

et al. 2012

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“…Schilling et al [17] revealed that RUT was still less sensitive for diagnosis of Hp infection in patients of peptic ulcer bleeding without use of PPI. The presence of blood may reduce the sensitivity of RUT due to the bacteriocidal effect or inhibitors to suppress the urease activity in the serum [8,14,18]. The buffering effects of blood proteins may interfere with pH change and prevent color change of RUT [8,14].…”

Section: Discussionmentioning

confidence: 99%

Increasing Biopsy Number and Sampling from Gastric Body Improve the Sensitivity of Rapid Urease Test in Patients with Peptic Ulcer Bleeding

et al. 2014

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“…Although the urease test's sensitivity was somewhat lower than its specificity [21,22], and positive and negative predictive values, past research has revealed that proton pump inhibitors and H2-receptor antagonists decrease the sensitivity of rapid urease tests [23]. Other causes for the reduced sensitivity could be the possible buffering action of albumin [24] or a direct bactericidal effect of plasma [25]. We did not take into account the usage of either medication type in our bleeding ulcer sample group since some of them had already begun taking these medications prior to endoscopy for ulcer detection.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Involved in Patients with Bleeding Peptic Ulcers: A Case–Control Study

2008

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Our objectives were to (1) identify the risk factors involved in patients with peptic ulcer disease and determine if they predict bleeding in these patients, (2) determine the association between these risk factors, and (3) analyze the cost effectiveness of various tests for Helicobacter pylori (H. pylori). Two-hundred and thirty patients were included in our study between January 2004 and June 2005 (128 bleeding peptic ulcer disease patients constituted the cases, 102 nonbleeding ulcer patients constituted the controls). H. pylori infection was assessed by urease test and biopsy from gastric antrum. There was no statistically significant difference between these groups regarding sex, age, or location of ulcer. Nonsteroidal anti-inflammatory drug (NSAID) use was higher in the case group (P < 0.001), and the rate of H. pylori infection was lower in these patients (P < 0.05). There was no interaction between NSAID use and H. pylori infection in predicting bleeding ulcer risk (P = 0.08). Sensitivity and specificity for urease test in detecting H. pylori was 75% and 99.7%, respectively. So a positive urease test does not need confirmation with biopsy, which is cost effective.

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Human plasma is directly bacteriocidal against Helicobacter pylori in vitro, potentially explaining the decreased detection of Helicobacter pylori during acute upper GI bleeding

Cited by 39 publications

References 14 publications

Real-Time PCR for Diagnosing Helicobacter pylori Infection in Patients with Upper Gastrointestinal Bleeding: Comparison with Other Classical Diagnostic Methods

Real-Time PCR for Diagnosing Helicobacter pylori Infection in Patients with Upper Gastrointestinal Bleeding: Comparison with Other Classical Diagnostic Methods

Increasing Biopsy Number and Sampling from Gastric Body Improve the Sensitivity of Rapid Urease Test in Patients with Peptic Ulcer Bleeding

Risk Factors Involved in Patients with Bleeding Peptic Ulcers: A Case–Control Study

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