Rapid 13C Urea Breath Test to Identify Helicobacter pylori Infection in Emergency Department Patients with Upper Abdominal Pain (original) (raw)
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Epidemiology and Infection, 1997
Data on prevalence and determinants of Helicobacter pylori infection in well-defined populations are scarce. We investigated the prevalence and determinants of active H. pylori infection in a population of out-patients attending a general practitioner in Southern Germany. Infection status was determined by ["$C]urea breath test. In addition, information on potential risk factors and medical history was collected.
Houston Consensus Conference on Testing for Helicobacter pylori Infection in the United States
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2018
Despite guidelines for detection and treatment of Helicobacter pylori infection, recommendations to test patients before and after therapy are commonly not followed in the United States (US). At the Houston Consensus Conference, 11 experts on management of adult and pediatric patients with H pylori, from different geographic regions of the US, met to discuss key factors in diagnosis of H pylori infection, including identification of appropriate patients for testing, effects of antibiotic susceptibility on testing and treatment, appropriate methods for confirmation of infection and eradication, and relevant health system considerations. The experts divided into groups that used a modified Delphi panel approach to assess appropriate patients for testing, testing for antibiotic susceptibility and treatment, and test methods and confirmation of eradication. The quality of evidence and strength of recommendations were evaluated using the Grade system. The results of the individual worksh...
Identification of Helicobacter pylori infected patients, using administrative data
Alimentary Pharmacology & Therapeutics, 2008
Background Helicobacter pylori is a prevalent organism implicated in peptic ulcer disease. Aim To validate administrative data for diagnosis of H. pylori-infected patients. Methods Administrative data identified patients with ICD-9 code for H. pylori (041.86) or prescription of eradication therapy; diagnosis was confirmed by chart abstraction. Multivariable regression assessed predictors of infection considering drug therapy, ICD-9 code 041.86, procedure code, in-patient or outpatient diagnostic code, age, gender and race to generate an algorithm for validation. Results The test cohort of 531 patients (361 potential cases; 170 random controls) was primarily male (94%), Caucasian (59%) and elderly [67 years (s.d. 10)]. The positive predictive value (PPV) of ICD-9 code 041.86 was 100% and 97.4% if from an in-patient or outpatient encounter, respectively. Eradication drug therapy had a PPV of 73.7% (triple therapy) and 97.7% (quadruple therapy). The strongest predictors were outpatient ICD-9 code 041.86 (OR 8.1; 95% CI: 7.0-9.1); eradication drug therapy (OR 7.4; 95% CI: 6.6-8.3); oesophagogastroduodenoscopy (OR 3.5; 95% CI: 3.3-3.6); and age ‡70 (OR 1.2; 95% CI: 1.1-1.4). An algorithm including these data elements yielded a c-statistic of 0.93 and PPV of 97.9%. Conclusions Administrative data can diagnose H. pylori-infected patients. The diagnostic algorithm includes presence of eradication drug therapy overlapping with an outpatient ICD-9 code 041.86 among elderly adults.
The prevalence of Helicobacter pylori: Are Emergency Medicine residents at risk?
The Journal of Emergency Medicine, 2000
Helicobacter pylori is strongly associated with peptic ulcer disease and gastric cancer. It is a cause of chronic active gastritis. Our hypothesis was that Emergency Physicians might be at increased risk for infection due to their exposure to gastric contents from procedures performed in the Emergency Department. Our goal was to test a group of Emergency Physicians for H. pylori infection. In this cross sectional study, we tested a group of volunteers from an Emergency Medicine residency program for H. pylori infection by serum analysis for IgG. A matched control group was also tested. Forty-five subjects were enrolled; one subject's sample was lost. Three of 44 subjects (6.8%) were positive for H. pylori antibodies. Seven of 44 controls (15.9%) tested positive. Thus, Emergency Physicians do not have increased H. pylori infection rates and may be at less risk than the general population. Routine testing is not recommended.
Alimentary Pharmacology and Therapeutics, 2002
Background: The diagnostic yield of the stool antigen test (HpSA) in evaluating the results of Helicobacter pylori eradication therapy is controversial, but many studies have used only the 13 C-urea breath test (13 C-UBT) as a gold standard which has greatly reduced their relevance. Aim: To compare the reliability of HpSA and 13 C-UBT in patients post-treatment using biopsy-based methods as reference tests. Methods: A total of 100 consecutive dyspeptic patients (42 male and 58 female; mean age, 56 ± 18 years) were enrolled in our study. All patients were H. pylori positive on the basis of at least two biopsy-based methods, and underwent 1 week of treatment with various triple therapies. They were again endoscoped 4 weeks after completing therapy and six biopsy specimens were taken from the gastric antrum and corpus for rapid urease test, histology and culture. HpSA and 13 C-UBT were also performed within 3 days of the second endoscopy. Results: On the basis of biopsy-based tests, infection was eradicated in 77 patients but continued in 23. Three false negatives were observed with HpSA and two with 13 C-UBT. In contrast, the number of false positives was significantly higher (P < 0.01) with HpSA than with 13 C-UBT (nine vs. one), confirming the lower specificity of the former test. The overall accuracy of HpSA was 88% vs. 97% for 13 C-UBT (P < 0.02). Conclusions: HpSA has lower diagnostic value than 13 C-UBT in the evaluation of the outcome of anti-H. pylori therapy. 13 C-UBT remains the first-line diagnostic method to monitor eradication results. The use of HpSA should be reserved for those settings in which 13 C-UBT is not available.
World journal of gastroenterology : WJG, 2008
AIM: To evaluate the performance of commercially available immunochromatographic (ICT) and immunoblot tests covering the current infection marker CIM and conventional ELISA for the diagnosis of H pylori infection in adult dyspeptic patients. METHODS: Consecutive non-treated dyspeptic patients undergoing diagnostic endoscopy were tested for H pylori infection by culture, rapid urease test, and histology of gastric biopsy specimens. Serum from 61 H pylori infected and 21 non-infected patients were tested for anti-H pylori IgG antibodies by commercial ELISA (AccuBind TM ELISA, Monobind, USA), ICT (Assure ® H pylori Rapid Test, Genelabs Diagnostics, Singapore), and immunoblot (Helico Blot 2.1, Genelabs Diagnostics, Singapore) assays. ICT and immunoblot kits cover CIM among other parameters and their performance with and without CIM was evaluated separately. RESULTS: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of ELISA were 96.7%, 42.8%, 83.1%, 81.8%, and 82.9%, of ICT were 90.1%, 80.9%, 93.2%, 73.9%, and 87.8%, of ICT with CIM were 88.5%, 90.4%, 96.4%, 73.0%, and 89.0%, of immunoblot were 98.3%, 80.9%, 93.7%, 94.4%, and 93.9%, and of immunoblot with CIM were 98.3%, 90.4%, 96.7%, 95.0%, and 96.3%, respectively. CONCLUSION: Immunoblot with CIM had the best performance. ICT with CIM was found to be more specific and accurate than the conventional ELISA and may be useful for non-invasive diagnosis of H pylori infection. MS. Noninvasive diagnosis of H pylori infection: Evaluation of serological tests with and without current infection marker CIM. Saeed ZA, Malaty HM. Effect of treatment of Helicobacter pylori infection on the long-term recurrence of gastric or duodenal ulcer. A randomized, controlled study. Ann Intern Med 1992; 116: 705-708 4 Hosking SW, Ling TK, Chung SC, Yung MY, Cheng AF, Sung JJ, Li AK. Duodenal ulcer healing by eradication of Helicobacter pylori without anti-acid treatment: randomised controlled trial. Lancet 1994; 343: 508-510 5 Sung JJ, Chung SC, Ling TK, Yung MY, Leung VK, Ng EK, Li MK, Cheng AF, Li AK. Antibacterial treatment of gastric ulcers associated with Helicobacter pylori. N Engl J Med 1995; 332: 139-142 6
2015
Background: Infection with Helicobacter pylori (H. pylori) is associated with significant morbidity and mortality. Till now, the seroprevalence of H. pylori infection from this part of India has not been reported. Aim: To study the seroprevalence of H. pylori infection in patients with gastrointestinal disorders undergoing upper gastrointestinal endoscopy at a tertiary care government setup. Settings and Design: It is a single hospital based, cross-sectional, prospective study. Materials and Methods: The demographic data, blood sample to detect presence of H. pylori IgG by ELISA and gastric biopsy specimen for rapid urease test (RUT) were collected from eighty (80) patients. Statistics: Data analysis was carried out with GraphPad InStat statistical program. Prevalence rates are expressed as percentages. Unpaired t test was used to compare the continuous variable. P value < 0.05 was taken to be statistically significant. Fischer exact test was used to analyze categorical data. Res...
Acta Paediatrica, 2017
Aim-This study assessed the Helicobacter pylori (H. pylori) serum antibody test as a diagnostic screening tool in symptomatic inner city children. Methods-This was a retrospective study of patients aged 1-18 years who were referred to our paediatric gastroenterology department from 2009-2013. We included all patients who had H. pylori serum antibodies and, or, faecal antigens who underwent esophagogastroduodenoscopy (EGD) for histology, with or without a gastric tissue rapid urease test. Results-A total of 395 patients had EGDs carried out to evaluate epigastric pain, heartburn and nausea or vomiting and their overall socioeconomic Z-score was −2.62. The histology was positive for H. pylori infection in 52/395 patients (13%), and epigastric pain was documented in 45 of these 52 patients (87%). Compared to histology, the serum H. pylori antibody test had a sensitivity of 88.4% and a specificity of 93.4%. The tissue rapid urease test and faecal antigen test had sensitivities of 89.3% and 55.6% and specificities of 89.9% and 98.9%, respectively. Conclusion-The serum H. pylori antibody test had high sensitivity and specificity and it was a good diagnostic screening tool in our study. Epigastric pain was strongly associated with a current H. pylori infection in our population.
Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy
Objective: Helicobacter pylori (H. pylori) is a Gram-negative microaerophilic bacterium that is associated with diseases such as peptic ulcer, chronic gastritis, gastric MALT lymphoma, and gastric cancer. H. pylori infection is more common in developing countries. The high socioeconomic conditions and elimination of bacterial carriage by antimicrobial treatment reduce the prevalence of H. pylori in developed countries. The fecal H. pylori antigen test has been widely used recently. This test with high sensitivity and specificity constitutes a significant diagnostic method alternative due to its cost-effectiveness and rapid results. In this study, we retrospectively analyzed the presence of H. pylori antigen in the stool samples of patients with gastroduodenal complaints from laboratory records. Methods: Test results of patients who underwent H. pylori antigen rapid cassette test from fresh fecal samples between January 2018 and May 2022 in the Medical Microbiology Laboratory were included in the study. Fresh fecal samples from patients were analyzed using H. pylori Antigen Rapid Test Cassette (Acro Biotech Inc, USA) kits. The statistical analysis of the research was made with IBM-SPSS 25.0 (IBM Co., USA). The chi-square test was used to evaluate the research data. P<0.05 value was considered statistically significant. Results: A total of 5,718 patients, 3,285 (57.5%) women with gastroduodenal complaints, were included in the study. Fecal H. pylori antigen test positivity was determined in 1,429 (25%) of these patients. The antigen positivity rate was found to be higher in women (26.6%) compared to men (22.9%) (p<0.05). In addition, this rate was higher in adult patients (27.4%) than in pediatric patients (10.1%). In addition, this rate was higher in adult patients (27.4%) compared with pediatric patients (10.1%) (p<0.01). Conclusion: The regional prevalence data are informative about the development levels of countries in socioeconomic issues such as urbanization, infrastructure services, and access to clean water. In addition, these data may provide insight into the future prevalence of H. pylori-related diseases. We think that this study, in which the data of our region is shared, contributes to the literature.