Diagnostic methods for Helicobacter pylori infection: ideals, options, and limitations (original) (raw)
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Contemporary Diagnostic Strategies for the Detection of Helicobacter pylori Infection
Gastroenterology & hepatology, 2012
Helicobacter pylori infection is highly prevalent, affecting approximately half of the world's population. While the majority of infected individuals are asymptomatic, H. pylori infection is associated with certain diseases, including peptic ulcers (either duodenal or gastric), gastritis, and 2 malignancies-gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma. Many of the epidemiologic associations between these diseases and H. pylori infection have been further validated by treatment studies, which show that effective eradication therapy correlates with a decreased risk of disease. A variety of testing strategies are used to detect H. pylori infection. Serologic techniques are widely available and inexpensive, but they are no longer preferred as they have low sensitivities and specificities, and they may show a positive result for a long period following effective therapy. The remaining testing methods are divided into 2 categories: invasive tests (which requir...
Evaluation of Invasive and Noninvasive Methods for the Diagnosis of Helicobacter Pylori Infection
PubMed, 2016
Objective: The present study was conducted to evaluate invasive and noninvasive diagnostic methods for detection of Helicobacter pylori (H. pylori) in patients admitted with dyspeptic complaints and to compare sensitivities and specificities. Method: Sets of four gastric biopsy specimens were obtained from a total of 126 patients included in the study. The presence of H. pylori was determined by invasive tests including culture, rapid urease test, polymerase chain reaction (PCR) and histopathology. Among noninvasive tests, urea breath test, serological tests and enzyme-linked immunosorbent assay (ELISA) were performed. Results: H. pylori was isolated in 79 (62.7%) gastric biopsy cultures, whereas positivity was concluded for 105 (83.3%) patients by rapid urease test, for 106 (84.1%) by PCR, for 110 (87.3%) by histopathology, for 119 (94.4%) by urea breath test, and for 107 (84.9%) by ELISA. In the present study, the culture findings and histopathological examination findings were accepted as gold standard. According to the gold standard, urea breath test had the highest sensitivity (96.5%) and the lowest specificity (30%), whereas culture and histopathology had the highest specificities (100%). Conclusion: The use of PCR invasively with gastric biopsy samples yielded parallel results with the gold standard. PCR can be recommended for routine use in the diagnosis of H. pylori.
The present study was conducted to evaluate invasive and noninvasive diagnostic methods for detection of Helicobacter pylori (H. pylori) in patients admitted with dyspeptic complaints and to compare sensitivities and specificities. Method: Sets of four gastric biopsy specimens were obtained from a total of 126 patients included in the study. The presence of H. pylori was determined by invasive tests including culture, rapid urease test, polymerase chain reaction (PCR) and histopathology. Among noninvasive tests, urea breath test, serological tests and enzyme-linked immunosorbent assay (ELISA) were performed. Results: H. pylori was isolated in 79 (62.7%) gastric biopsy cultures, whereas positivity was concluded for 105 (83.3%) patients by rapid urease test, for 106 (84.1%) by PCR, for 110 (87.3%) by histopathology, for 119 (94.4%) by urea breath test, and for 107 (84.9%) by ELISA. In the present study, the culture findings and histopathological examination findings were accepted as gold standard. According to the gold standard, urea breath test had the highest sensitivity (96.5%) and the lowest specificity (30%), whereas culture and histopathology had the highest specificities (100%). Conclusion: The use of PCR invasively with gastric biopsy samples yielded parallel results with the gold standard. PCR can be recommended for routine use in the diagnosis of H. pylori.
Istanbul Medical Journal, 2018
Helicobacter pylori is a common pathogen that colonizes the gastric epithelium with a high infection prevalence (1). H. pylori infection risk increases due to insufficiency of socioeconomic conditions and inability to create healthy living conditions. Many gastrointestinal illnesses are associated with H. pylori such as gastritis, gastric and duodenal ulcer, and malignancies (2). Gastroduodenal ulcers can cause gastrointestinal bleeding. H. pylori is detected in more than 70% of cases of gastric ulcer and 90% of cases of duodenal ulcer (3). Its eradication leads to a significant reduction in the incidence of recurrent upper gastrointestinal bleeding (4). Many conventional diagnostic methods fail to identify H. pylori especially in patients with upper gastrointestinal bleeding. However, some studies have shown that polymerase chain reaction (PCR)-based methods are more reliable than the other techniques for the diagnosis of cases with upper gastrointestinal bleeding (5). The accurate detection of H. pylori is essential for the management and eradication of bacteria in related cases. The diagnosis is based on both invasive and non-invasive methods. Invasive diagnostic tests include endoscopy followed by histopathological examination of biopsy specimens, fast urease test, and direct identification of the microorganism using culture. Non-invasive methods comprise urea breath test, antibody detection using serology, and stool antigen test (6). The aim of the current study was to compare invasive and non-invasive tests for the detection of H. pylori in patients with gastroduodenal disease. Antibiotic susceptibility test results were also evaluated for H. pylori strains. Methods Patients The present study was planned retrospectively. Data included 87 patients who had been evaluated
Background: Helicobacter pylori (H. pylori) is a Gram-negative, microaerophilic bacterium it is one of the most common human-specific pathogens which exclusively inhabits the gastric mucosa. Infection with H. pylori is always associated with chronic gastric inflammation, gastritis and peptic ulceration which can lead to gastric cancers such as adenocarcinoma. The aim of this study was to compare between three non invasive methods used for diagnosing Helicobacter pylori infection. Methodology: this study was conducted in Khartoum state from February to May 2017. Stool and serum samples were collected from 105 patients with gastric disorders. The presence of H.pylori infection was evaluated by urea breath test, stool antigen detection test and antibody detection test. Results: A total number of 45 patients gave positive result in urea breath test while 60 patients' showed negative result.44 patients gave positive result in stool antigen test while 61 patients showed negative result. A total number of 40 patients gave positive result in antibody detection test while 65 patients' showed negative result. The result showed that the similarity between urea breath test, stool antigen test, urea breath test, antibody detection test and stool antigen test, antibody detection test was 99%, 72,4% and 71,4 % respectively.
Invasive and Non-Invasive Methods of Diagnosing H. pylori Infection: A Review of Current Practice
IntechOpen eBooks, 2024
H. pylori infection can be diagnosed using both noninvasive and invasive methods. There is no one gold standard test that is used for diagnosis. Invasive methods of diagnosis involve endoscopy with biopsy, histologic examination, culture, and rapid urease testing. There are certain clinical situations that are appropriate for noninvasive testing and invasive testing. Choosing the appropriate method of diagnosis is dependent upon multiple factors including pretest probability of Infection as well as cost-effectiveness and availability. The aim of this chapter is to discuss the current options of diagnosis, when invasive testing is indicated, and the interpretation of the results obtained.
Diagnosis of Helicobacter pylori infection by invasive and noninvasive tests
Brazilian Journal of Microbiology, 2013
Although several invasive and noninvasive tests have been developed for the diagnosis of Helicobacter pylori infection, all of the tests have their limitations. We conducted a study to investigate and compare the suitability of rapid urease test (RUT), serology, histopathology and stool antigen tests with polymerase chain reaction (PCR) for detection of H. pylori, and correlate the diagnostic methods with PCR. Eighty nine patients (61 adults, 28 children) referred to the Firoozgar Hospital and Children Medical Center Hospital for diagnostic upper gastrointestinal endoscopy entered to the study and noninvasive tests such as immunoassay for serological antibodies against H. pylori and detection of its antigen in feces were measured. The biopsies were utilized for histological examination, RUT and PCR. The H. pylori statuses were evaluated by the positivity of ureC PCR in biopsy specimens and 53 subjects had H. pylori positive result. Histopathology showed high overall performance in adults and children with sensitivity and specificity 100% and 90%, respectively. Sensitivity, specificity, and accuracy for stool antigen test were 87.8%, 75% and 82%, respectively. Correlation of RUT, serology (IgG), histopathology and stool antigen tests with PCR were 0.82, 0.32, 0.91 and 0.63, respectively. In conclusion, the RUT and histopathology are as accurate as the PCR of biopsy and stool antigen test can consider as appropriate noninvasive test for detection of H. pylori infection.
Archives of Medical Research, 2006
Background. Invasive and noninvasive tests are used for the diagnosis of Helicobacter pylori infection. The aim of this study was to determine the diagnostic utility of rapid urease test (RUT), culture, histology and serology for the diagnosis of H. pylori in patients with different clinical presentations. Methods. We studied 527 consecutive patients (mean age, 52.5 years; F:M, 1.3; age range 15-89 years) enrolled at the Hospital Universitario, Universidad Autónoma de Nuevo León. Patients had gastric cancer (GC, 9.1%), non-ulcer dyspepsia (NUD, 81.4%), or peptic ulcer disease (PUD, 9.1%). The infection by H. pylori was determined by histology, rapid urease test, culture, and serology. Patients were determined as infected with H. pylori if at least a) two invasive tests were positive and b) two tests were positive (invasive or non-invasive). Diagnostic utility was calculated for each assay.