More economic 25 mg ¹³C‐urea breath test can be effective in detecting primary Helicobacter pylori infection in children

Abstract

Lower-dose UBT titration by bodyweight can cut costs while maintaining a highly reliable method to screen primary H. pylori infection in children older than 7 years, which is generally beyond school age.

Diagnosis of Helicobacter pylori Infection by Means of Reduced‐Dose 13C‐Urea Breath Test and Early Sampling of Exhaled Breath

“…The criterion standard was composed of concordant noninvasive tests (standard dose 13 C-UBT and polyclonal stool antigen test) (13). The low prevalence of infection in this study (13.1%) made the sample size insufficient, as noted by the wide 95% confidence interval for S. Moreover, 1 of the tests used as the criterion standard (polyclonal stool antigen test) presented limited S in younger patients (<6 years) (25), which may have influenced the results.…”

“…Accordingly, reducing the number of breath samples collected (7,8) and reducing 13 C-urea dose are important modifications (9)(10)(11)(12).…”

“…We evaluated the accuracy of the 13 C-UBT with an optimized protocol to diagnose H pylori infection in group of children and adolescents using 25 mg of 13 C-urea, with sampling of exhaled breath at 10 (T 10 ), 20 (T 20 ), and 30 (T 30 ) minutes after ingestion of this substrate.…”

Improved Performance of a Rapid Office-Based Stool Test for Detection of Helicobacter pylori in Children before and after Therapy

“…A major advantage of fecal tests is the independence of the test accuracy from the child's age. While both serology (6,12) and UBT (10,11,25) perform with lower accuracy in young children, this is not the case for stool tests. Our study included a larger proportion of very young patients than recent studies of fecal antigen tests (16,23).…”

“…Serological tests are not appropriate, since they cannot distinguish between a present and previous infection and, in addition, they have a low sensitivity in children younger than 12 years of age (6, 13). The [ 13 C]urea breath test (UBT) is the preferred noninvasive diagnostic tool and gives excellent performance for both adults and children, but specificity decreases in very young and mentally disabled children who are not able to cooperate with the test procedure (10,11,25). So far, tests for detection of H. pylori antigen in stool samples are the only noninvasive diagnostic tools which do not show an age dependence for the diagnostic accuracy (14, 15).…”