Letter: effect of proton pump inhibitor use on invasive detection of<i>Helicobacter pylori</i>gastritis - authors' reply

Genta, Robert M.; Sonnenberg, Amnon

doi:10.1111/apt.13093

Cited by 1 publication

(1 citation statement)

References 6 publications

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“…Kiss et al ( 20 ) showed that approximately 50% of histological gastritis and H. pylori- negative are PCR positive. Some authors suggest that patients with chronic active gastritis in the absence of visible H. pylori should be considered as infected individuals in whom H. pylori has temporarily disappeared from the mucosa because of PPI or antibiotic use ( 38 ). This topic remains, however, unclear.…”

Section: Discussionmentioning

confidence: 99%

Droplet Digital PCR Detects Low-Density Infection in a Significant Proportion of Helicobacter Pylori-Negative Gastric Biopsies of Dyspeptic Patients

Ramírez‐Lázaro

Lario

Quilez

et al. 2020

Clinical and Translational Gastroenterology

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INTRODUCTION: Helicobacter pylori- infected individuals may present low-density infection, undetectable by conventional tests such as histology, rapid urease test, or urea breath test. Droplet digital polymerase chain reaction (ddPCR) is more sensitive than other polymerase chain reaction methods. We aimed to evaluate the ability of ddPCR to detect H. pylori infection in patients diagnosed as negative by conventional tests. METHODS: Dyspeptic patients (n = 236) were tested for H. pylori by histology, urea breath test, and rapid urease test. Patients were classified as having 3 positive (n = 25, control group), 2 positive (n = 12), one positive (n = 41), or zero positive (n = 158) diagnostic tests. DNA was extracted from gastric biopsies. Triplicate ddPCR testing for each of the 16S rDNA, ureA, and vacA(s) genes was performed using a QX200 ddPCR system (Bio-Rad). A gene was considered positive when detected by at least 2 of 3 repeated ddPCRs. H. pylori positivity was defined as having 2 or more positive genes. RESULTS: All the biopsies of the control patients were positive for all 3 16S rDNA, ureA, and vacA(s) genes. H. pylori infection was detected in 57 (36%), 22 (54%), and 9 (75%) patients with zero, 1, and 2 positive diagnostic tests, respectively. The density of infection was 5, 121, 599, and 3,133 copies of H. pylori genome equivalents for patients with zero, 1, and 2 of 3 positive test results and for the control group, respectively. DISCUSSION: ddPCR detected low-density “occult” H. pylori infection in a significant proportion (36%) of patients diagnosed as negative by conventional methods. The number of conventional positive tests was related to the density of infection.

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Section: Discussionmentioning

confidence: 99%