Influencing Factors to Results of the Urease Test: Age, Sampling Site, Histopathologic Findings, and Density ofHelicobacter pylori

Abstract

PurposeWe investigated the positivity rate and the time period to the positive color change of the urease test in children and adults and assessed the correlation of the urease test to histopathologic findings.MethodsFrom 1995 to 2000, endoscopic biopsies of the antrum and body were collected from 811 children and 224 adults and subjected to urease tests and histopathology.ResultsThe positivity rate of the urease test was 49.4% for 0-4 years, 48.4% for 5-9 years, 47.3% for 10-15 years, and 62.5% for 20-29 years in the antrum. The positivity rate was 85.1% in 0-4 years, 82.3% in 5-9 years, 74.7% in 10-15 years, and 74.1% in 20-29 years for the body. In the antrum, the highest positivity rate was <1 hour for the group aged 10-29 years and 6-24 hours in the group <10 years old (p<0.0001). In the body, the highest positivity rate was <1 hour in adults and 6-24 hours in children (p<0.0001). The proportions of the positive reactions within 1 hour were similar for the antrum and the body. In the cases of more severe chronic gastritis, active gastritis, and Helicobacter pylori infiltration, a positive urease test reaction occurred more quickly (p<0.0001).ConclusionThere were significant differences in urease tests according to age and sampling site. The discrepancy between the antrum and the body was greater in younger children. These results might be related to the low density and patchy distribution of bacteria in children and in the body.

Correlation between Positive Rate and Number of Biopsy Samples on Urease Test in ChildhoodHelicobacter pyloriInfection

“…In the current study, we reported that the positive rate of urease test was higher on antral and body biopsy samples as compared with antral one in the children (10). This is the first attempt to compare the positive rate and time to positive reaction between one and three biopsy samples in the same children.…”

Association between Gastric pH andHelicobacter pyloriInfection in Children

“…A previous study identified the sampling site of gastric biopsy examination, histopathologic findings, and the H. pylori load as factors that influence the results of the urease test [ 9 ]. Further, several conditions can lead to false-negative results in the urease test, the two most common of which are the recent use of proton-pump inhibitors (PPIs) and the presence of intestinal metaplasia [ 7 ].…”

Review: Prevalence and dynamics of Helicobacter pylori infection during childhood

“…The cross‐sectional studies on H. pylori infection in symptomatic children as detected by histology are summarized in Figure [references: ] . H. pylori prevalence estimates vary greatly (3%‐76%) with an overall random‐effects regression model estimate of 39% (95% CI: 35%‐43%).…”