Review: Diagnosis of Helicobacter pylori infection

Abstract

Endoscopic imaging of the stomach is improving. In addition to narrow band imaging, other methods, for example, blue light imaging and linked color imaging, are now available and can be combined with artificial intelligence systems to obtain information on the gastric mucosa and detect early gastric cancer. Immunohistochemistry is only recommended as an ancillary stain in case of chronic active gastritis without Helicobacter pylori detection by standard staining, and recommendations to exclude false negative H. pylori results have been made. Molecular methods using real‐time PCR, droplet digital PCR, or amplification refractory mutation system PCR have shown a high accuracy, both for detecting H. pylori and for clarithromycin susceptibility testing, and can now be used in clinical practice for targeted therapy. The most reliable non‐invasive test remains the 13C‐urea breath test. Large data sets show that DOB values are higher in women and that the cut‐off for positivity could be decreased to 2.74 DOB. Stool antigen tests using monoclonal antibodies are widely used and may be a good alternative to UBT, particularly in countries with a high prevalence of H. pylori infection. Attempts to improve serology by looking at specific immunodominant antigens to distinguish current and past infection have been made. The interest of Gastropanel® which also tests pepsinogen levels was confirmed.

Diagnostic reliability of nested PCR depends on the primer design and threshold abundance ofHelicobacter pyloriin biopsy, stool, and saliva samples

“…Consequently, the most plausible explanation is that the nested PCR assay has similar sensitivity to 13 C‐UBT in detecting H pylori in samples with low urease activity. This is in good agreement with the recent reports that various PCR modifications have a high accuracy for detecting H pylori and can be used in clinical practice …”

“…C-UBT in detecting H pylori in samples with low urease activity. This is in good agreement with the recent reports that various PCR modifications have a high accuracy for detecting H pylori and can be used in clinical practice 46,47. Analyses of stool specimens revealed the opposite situation.According to the SAT test, 22 samples were H pylori positive, while less than half were positive by nested PCR.…”

Transformation of Helicobacter pylori into Coccoid Forms as a Challenge for Research Determining Activity of Antimicrobial Substances

“…The colonization of over 60% of people in the world by H. pylori and a direct involvement of this bacterium in the development of many gastrointestinal diseases, including cancers, have contributed to the high intensity of research conducted on epidemiology, diagnostics, and treatment of this microorganism [4][5][6][7]. Since 2000, more than 35,000 scientific reports on H. pylori have been published in PubMed, while only a fraction of them tried to find a link between the exposure to antimicrobial substances and H. pylori morphological changes.…”

“…The prevalence of H. pylori and its impact on human health have contributed to the high intensity of research focusing on epidemiology, diagnostics, and treatment of this microorganism [5][6][7]. Because nowadays antibiotics are the only accepted form of combating H. pylori, the resistance of this microorganism to these medications is an alarming problem [8].…”

Diagnosis ofHelicobacter pyloriinfection in the elderly using an immunochromatographic assay‐based stool antigen test

“…Helicobacter pylori infection is considered an infectious disease, regardless of symptoms and the stage of the disease (Sugano, Tack, & Kuipers, 2015). Along with increasing age, the prevalence of H. pylori infection is elevated in developing countries (Bardhan, 1997 (Makristathis, Hirschl, & Megraud, 2019). is the most widely studied and preferentially recommended a noninvasive approach for the "test-and-treat strategy" (Malfertheiner et al, 2017).…”