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Archives of Medical Science
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vol. 14
Clinical research

Stool antigen detection versus 13C-urea breath test for non-invasive diagnosis of pediatric Helicobacter pylori infection in a limited resource setting

Mortada El-Shabrawi, Nabil Abd El-Aziz, Tarek Zakaria El-Adly, Fetouh Hassanin, Ayman Eskander, Maha Abou-Zekri, Hala Mansour, Safa Meshaal

Arch Med Sci 2018; 14, 1: 69–73
Online publish date: 2016/07/01
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Introduction: The prevalence of childhood infection with Helicobacter pylori is high, especially in developing countries. Non-invasive methods for detection of infection in children should be inexpensive, easy to perform, well tolerated and have a high diagnostic accuracy. We aimed to compare the reliability, specificity and sensitivity of the H. pylori stool antigen (HpSA) test with the 13C-urea breath test (13C-UBT) for the diagnosis of H. pylori infection in a limited resource setting.

Material and methods: The stool samples of 60 symptomatic and dyspeptic children with a mean age of 7.2 ±3.7 years (2–15 years) were evaluated using the rapid One step HpSA test by lateral flow immunoassay. The 13C-UBT was used as the gold standard method for the diagnosis of H. pylori infection.

Results: The HpSA test detected H. pylori antigen in 34 out of 38 positive patients with 4 false-negatives (sensitivity 89.5%, 95% confidence interval (CI): 75.2–97.1%), while 21 patients had true-negative results and one false-positive (specificity 95.5%, 95% CI: 77.2–99.9%), with a strong measure of agreement between the HpSA test and the 13C-UBT ( = 0.83, 95% CI: 68–97%, p < 0.001). It had a positive predictive value of 97.1% (95% CI: 85.1–99.9%), a negative predictive value of 84% (95% CI: 63.9–95.5%) and an accuracy of 91.7%.

Conclusions: The rapid lateral flow HpSA test is a reliable method for the primary diagnosis of H. pylori infections in children, though not as accurate as the 13C-UBT. It is more affordable, simpler to perform and more tolerable, representing a viable alternative, especially in developing countries.

Helicobacter pylori, H pylori stool antigen test, 13C-urea breath test

Perez-Perez GI, Rothenbacher D, Brenner H. Epidemiology of Helicobacter pylori infection. Helicobacter 2004; 9: 1-6.
Silva JM, Villares CA, Monteiro Mdo S, Colauto C, dos Santos AF, Mattar R. Validation of a rapid stool antigen test for diagnosis of Helicobacter pylori infection. Rev Inst Med Trop Sao Paulo 2010; 52: 125-8.
Ni YH, Lin JT, Huang SF, Yang JC, Chang MH. Accurate diagnosis of Helicobacter pylori infection by stool antigen test and 6 other currently available tests in children. J Pediatr 2000; 136: 823-7.
Biernat MM, Poniewierka E, Błaszczuk J, et al. Antimicrobial susceptibility of Helicobacter pylori isolates from Lower Silesia, Poland. Arch Med Sci 2014; 10: 505-9.
Mattar R, Monteiro MS, Marques SB, Zilberstein B, Hashimoto CL, Carrilho FL. Association of LEC and tnpA Helicobacter pylori genes with gastric cancer in a Brazilian population. Infect Agents Cancer 2010; 5: 1.
Ahmed KS, Khan AA, Ahmed I, et al. Impact of household hygiene and water source on the prevalence and transmission of Helicobacter pylori: a South Indian perspective. Singapore Med J 2007; 48: 543-9.
Kusters JG, van Vilt AHM, Kuipers EJ. Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev 2006; 19: 449-90.
Sherif M, Mohran Z, Fathy H, Rockabrand D, Rozmajzl PJ, Frenck RW. Universal high-level primary metronidazole resistance in Helicobacter pylori isolated from children in Egypt. J Clin Microbiol 2004; 42: 4832-4.
Kuloğlu Z, Kansu A, Kirsaçlioğlu CT, et al. A rapid lateral flow stool antigen immunoassay and (14)C-urea breath test for the diagnosis and eradication of Helicobacter pylori infection in children. Diagn Microbiol Infect Dis 2008; 62: 351-6.
Gulcan EM, Varol A, Kutlu T, et al. Helicobacter pylori stool antigen test. Indian J Pediatr 2005; 72: 675-8.
Malfertheiner P, Megraud F, O’Morain C, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut 2007; 56: 772-81.
Kato M, Saito M, Fukuda S, et al. 13C-urea breath test, using a new compact nondispersive isotope-selective infrared spectrophotometer: comparison with mass spectrometry. J Gastroenterol 2004; 39: 629-34.
Jelski W, Laniewska-Dunaj M, Strumnik A, Szmitkowski M. The alcohol dehydrogenase isoenzyme alcohol dehydrogenase IV as a candidate marker of Helicobacter pylori infection. Arch Med Sci 2014; 10: 951-5.
Torres J, Leal-Herrera Y, Ramos I, Madrazo-de la Garza A, Monath T, Muñoz O. Comparison of H. pylori reinfection and primary acquisition in children from a community with high prevalence of infection. Gut 1999; 45 (Suppl III): A95.
Baumann AJ. Helicobacter pylori antigen test. Philadelphia, USA: Department of internal Medicine Albert Einstein Medical Center; 2014. Available from http://emedicine.medscape.com/article/2117821-overview. Accessed July 23rd, 2015.
de Carvalho Costa Cardinali L, Rocha GA, Rocha AM, et al. Evaluation of [13C]urea breath test and Helicobacter pylori stool antigen test for diagnosis of H. pylori infection in children from a developing country. J Clin Microbiol 2003; 41: 3334-5.
Konstantopoulos N, Rüssmann H, Tasch C, et al. Evaluation of the Helicobacter pylori stool antigen test (HpSA) for detection of Helicobacter pylori infection in children. Am J Gastroenterol 2001; 96: 677-83.
Kato S, Nakayama K, Minoura T, et al. Comparison between the 13C-urea breath test and stool antigen test for the diagnosis of childhood Helicobacter pylori infection. J Gastroenterol 2004; 39: 1045-50.
Domínguez J, Forné M, Blanco S, et al. Comparison of a monoclonal with a polyclonal antibody-based enzyme immunoassay stool test in diagnosing Helicobacter pylori infection before and after eradication therapy. Aliment Pharmacol Ther 2006; 23: 1735-40.
Veijola L, Myllyluoma E, Korpela R, Rautelin H. Stool antigen tests in the diagnosis of Helicobacter pylori infection before and after eradication therapy. World J Gastroenterol 2005; 11: 7340-4.
Hooton C, Keohane J, Clair J, et al. Comparison of three stool antigen assays with the 13C-urea breath test for primary diagnosis of Helicobacter pylori infection and monitoring treatment outcome. Eur J Gastroenterol Hepatol 2006; 18: 595-9.
Syam AF, Rani AA, Abdullah M, et al. Accuracy of Helicobacter pylori stool antigen for the detection of Helicobacter pylori infection in dyspeptic patients. World J Gastroenterol 2005; 11: 386-8.
Blanco S, Forné M, Lacoma A, et al. Comparison of stool antigen immunoassay methods for detecting Helicobacter pylori infection before and after eradication treatment. Diagn Microbiol Infect Dis 2008; 61: 150-5.
Peitz U, Leodolter A, Kahl S, et al. Antigen stool test for assessment of Helicobacter pylori infection in patients with upper gastrointestinal bleeding. Aliment Pharmacol Ther 2003; 17: 1075-84.
Krausse R, Müller G, Doniec M. Evaluation of a rapid new stool antigen test for diagnosis of Helicobacter pylori infection in adult patients. J Clin Microbiol 2008; 46: 2062-5.
Yang HR, Seo JK. Helicobacter pylori stool antigen (HpSA) tests in children before and after eradication therapy: comparison of rapid immunochromatographic assay and HpSA ELISA. Dig Dis Sci 2008; 53: 2053-8.
Elwyn G, Taubert M, Davies S, Brown G, Allison M, Phillips C. Which test is best for Helicobacter pylori? A cost-effectiveness model using decision analysis. Br J Gen Pract 2007; 57: 401-3.
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