AIM： To compare two different H pylori stool antigen tests as noninvasive diagnostic methods. METHODS： The study population consisted of 22 upper gastrointestinal system bleeding patients. Urea breath test （UBT）, ...AIM： To compare two different H pylori stool antigen tests as noninvasive diagnostic methods. METHODS： The study population consisted of 22 upper gastrointestinal system bleeding patients. Urea breath test （UBT）, rapid urease test （RUT） and histopathological examination were applied to all patients. Stool specimens from these patients were examined by rapid STPIP!HpSA and one step simple H pylori antigen cassette test for the detection of Hpylori antigens. RESULTS： For these 22 patients, 15 （68.2%） were diagnosed as positive and seven （31.8%） were diagnosed negative for H pylori infection by the gold standard methods. Whereas 10 （45.5%） were positive and 12 （54.5%） were diagnosed negative by the rapid STPIP!HpSA test. The sensitivity, specificity, positive and negative predictive values were 60%, 86%, 90% and 50%, respectively. When compared to the gold standard methods, these differences were not significant. However, six patients （27.3%） were positive, and 16 （72.7%） were negative by the simple H pylori stool antigen cassette test. The sensitivity, specificity, positive and negative predictive values were 33%, 86%, 83% and 38%, respectively. Compared to the gold standard methods, the simple H pylori stool antigen cassette test results were significantly different （P = 0.012）. CONCLUSION： Rapid STRIP!HpSA test could be used as a routine diagnostic tool in the microbiology laboratory for assessing clinical significance and eradication control of H pylori in upper gastrointestinal system bleeding patients.展开更多
Stool antigen tests(SATs)are noninvasive diagnostic modules for Helicobacter pylori(H.pylori)infection.Two types of SATs exist for the diagnosis of H.pylori infection,one based on enzyme immunoassay(EIA)and another on...Stool antigen tests(SATs)are noninvasive diagnostic modules for Helicobacter pylori(H.pylori)infection.Two types of SATs exist for the diagnosis of H.pylori infection,one based on enzyme immunoassay(EIA)and another on immunochromatography(ICA).SATs do not require expensive chemical agents or specified equipment;hence,they are less expensive compared with the urea breath test.Both European and Japanese guidelines have shown that EIA-based SATs using monoclonal antibodies are useful for primary diagnosis as well as for the assessment of eradication therapy.ICA-based tests do not require particular equipment and are therefore useful in developing countries.SATs are also useful for the diagnosis of H.pylori infection in children and post gastric surgery patients.SATs performed via EIA can assess H.pylori infection in a large number of subjects,almost as well as serology.Thus,SATs would be useful or detecting current infection in such a survey to identify and eradicate H.pylori infection.The accuracy of SATs is lower when the stool samples are unformed or watery,because H.pylorispecific antigens in the stool samples are diluted.Temperature and the interval between stool sample collection and measurement also affect the results of SATs.The choice of test kit depends on the sensitivity and specificity in each region and the circumstances of each patient.展开更多
AIM: To investigate the effects of proton pump inhibitor (PPI) treatment on stool antigen test using the TestMate pylori enzyme immunoassay. METHODS: This study assessed 28 patients [16 men and 12 women; mean age (63....AIM: To investigate the effects of proton pump inhibitor (PPI) treatment on stool antigen test using the TestMate pylori enzyme immunoassay. METHODS: This study assessed 28 patients [16 men and 12 women; mean age (63.1 ± 5.9) years; range, 25-84 years] who underwent stool antigen test and urea breath test (UBT) before and after PPI administration. RESULTS: Using the UBT as the standard, the sensitivity, specif icity and agreement of the stool antigen test in all 28 patients were 95.2%, 71.4%, and 89.3%, respectively, before PPI administration, and 88.9%, 90.9%, and 89.3%, respectively, after PPI treatment. Mean UBT values were 23.98% ± 5.33% before and 16.19% ± 4.75% after PPI treatment and, in 15 patients treated for ≥ 4 wk, were signif icantly lower after than before 4 wk of PPI treatment (12.58% ± 4.49% vs 24.53% ± 8.53%, P = 0.048). The mean optical density (A450/630) ratios on the stool antigen test were 1.16 ± 0.20 before and 1.17 ± 0.24 after PPI treatment (P = 0.989), and were 1.02 ± 0.26 and 0.69 ± 0.28, respectively, in the group treated for > 4 wk (P = 0.099).展开更多
AIM： To evaluate the agreement between a mAb-based stool test （HP STAR） and the urea breath test （UBT） in monitoring （H pylon） infection after eradication therapy. METHODS： Patients with discordant results on ...AIM： To evaluate the agreement between a mAb-based stool test （HP STAR） and the urea breath test （UBT） in monitoring （H pylon） infection after eradication therapy. METHODS： Patients with discordant results on UBT and Hp STAR underwent endoscopy with biopsies for rapid urease test, culture, and histology to confirm H pylori status. RESULTS： Among 250 patients （50±14 years）, 240 （96.0%） had concordant UBT and Hp STAR tests with a significant correlation between DOB and A values （R = 0.87; P〈0.0001）. The remaining 10 （4.0%） patients had discordant tests （positive Hp STAR and negative UBT） with the Hp STAR inaccurate in five cases （false positive） and UBT inaccurate in the other five cases （false negative）. The “maximal expected” sensitivity, specificity, ＋PV, -PV, ＋LR, and -LR were 91%, 100%, 100%, 97.4%, ∞, and 8.2 respectively, for the UBT, and 100%, 97.4%, 91%, 100%, 38.8, and 0, respectively, for the Hp STAR. Overall accuracy for both tests was 98%. CONCLUSION： Both the UBT and the Hp StAR are equally accurate in monitoring H pylori infection. Nowadays, the choice of the “best” non-invasive H pylori test in the post-treatment setting should be done not only in terms of diagnostic accuracy but also in view of cost and local facilities.展开更多
Introduction: Helicobacter pylori (H. pylori) is an important bacterial pathogen, predominantly in undeveloped countries and regions. We conducted this study to investigate the presence of H. pylori antigen in the sto...Introduction: Helicobacter pylori (H. pylori) is an important bacterial pathogen, predominantly in undeveloped countries and regions. We conducted this study to investigate the presence of H. pylori antigen in the stool specimens of children, in Tekirdag, Turkey. Material and Methods: Stool specimens of 1441 children aging between 0 month to 15 years, with the complaints of abdominal pain, anemia, gastroenteritis, nausea and vomiting were included in the study. The subjects were divided into three groups based on their ages: Group A (0 month - 5 years), Group B (6 - 10 years) and Group C (11 - 15 years). All specimens were tested for H. pylori antigen with HP Ag (DIA.PRO, Diagnostic Bioprobes, Italy). Results were evaluated statistically. Results: The median age of children with H. pylori positive samples was 6.6 ± 4.1 and 47.9% were girls. Overall positivity of H. pylori stool antigen was 6.6%. Positivity rates due to ages in Groups A, B and C were: 8.9%, 5.8%,? 5.2% respectively (x2 = 9.3, p = 0.01). No difference was observed due to gender (x2 = 0.17, p = 0.68). Conclusion: Higher antigen positivity obtained in 0 - 5 years group, indicates the risk of acquiring the infection in early years of life. Preventive measures for the development of H. pylori infection gain importance, especially in developing countries.展开更多
BACKGROUND Standard triple therapy is an effective treatment for eradicating Helicobacter pylori infection,but it is encountered with drug resistance.The stool antigen test is a cost-effective and easy-to-perform test...BACKGROUND Standard triple therapy is an effective treatment for eradicating Helicobacter pylori infection,but it is encountered with drug resistance.The stool antigen test is a cost-effective and easy-to-perform test to confirm the eradication of H.pylori,4-8 weeks post-therapy,with 86%sensitivity and 92%specificity.AIM To assess the H.pylori eradication rate of standard triple therapy and factors affecting the eradication rate.METHODS We conducted a prospective,multicenter follow-up study in Addis Ababa,Ethiopia,at selected healthcare facilities among dyspeptic patients with positive stool H.pylori antigen tests from June 1,2023 to October 30,2023 to assess the H.pylori eradication rate.After completing the standard triple therapy,the eradication was confirmed using a stool antigen test 4 weeks later.The data were analyzed using bivariate and multivariate logistic regression methods.RESULTS The H.pylori eradication rate was 85.4%.Patients with a previous diagnosis of H.pylori infection,smokers,and local alcohol consumption were associated with a lower H.pylori eradication rate,with adjusted odds ratio(AORs)of 0.159[95%confidence interval(CI):0.050-0.511],0.206(95%CI:0.052-0.822),and 0.228(95%CI:0.052-0.997),respectively.Patients with complete symptom resolution were 5.383 times more likely to achieve eradication than patients without symptom improvement,AOR=5.383,95%CI:1.74-21.089.CONCLUSION H.pylori eradication rate was lower than expected.Post-treatment testing is crucial to confirm eradication and guide further management,such as susceptibility testing.展开更多
Considering the recommended indications for Helicobacter pylori(H.pylori)eradication therapy and the broad spectrum of available diagnostic methods,a reliable diagnosis is mandatory both before and after eradication t...Considering the recommended indications for Helicobacter pylori(H.pylori)eradication therapy and the broad spectrum of available diagnostic methods,a reliable diagnosis is mandatory both before and after eradication therapy.Only highly accurate tests should be used in clinical practice,and the sensitivity and specificity of an adequate test should exceed 90%.The choice of tests should take into account clinical circumstances,the likelihood ratio of positive and negative tests,the cost-effectiveness of the testing strategy and the availability of the tests.This review concerns some of the most recent developments in diagnostic methods of H.pylori infection,namely the contribution of novel endoscopic evaluation methodologies for the diagnosis of H.pylori infection,such as magnifying endoscopy techniques and chromoendoscopy.In addition,the diagnostic contribution of histology and the urea breath test was explored recently in specific clinical settings and patient groups.Recent studies recommend enhancing the number of biopsy fragments for the rapid urease test.Bacterial culture from the gastric biopsy is the gold standard technique,and is recommended for antibiotic susceptibility test.Serology is used for initial screening and the stool antigen test is particularly used when the urea breath test is not available,while molecular methods have gained attention mostly for detecting antibiotic resistance.展开更多
文摘AIM： To compare two different H pylori stool antigen tests as noninvasive diagnostic methods. METHODS： The study population consisted of 22 upper gastrointestinal system bleeding patients. Urea breath test （UBT）, rapid urease test （RUT） and histopathological examination were applied to all patients. Stool specimens from these patients were examined by rapid STPIP!HpSA and one step simple H pylori antigen cassette test for the detection of Hpylori antigens. RESULTS： For these 22 patients, 15 （68.2%） were diagnosed as positive and seven （31.8%） were diagnosed negative for H pylori infection by the gold standard methods. Whereas 10 （45.5%） were positive and 12 （54.5%） were diagnosed negative by the rapid STPIP!HpSA test. The sensitivity, specificity, positive and negative predictive values were 60%, 86%, 90% and 50%, respectively. When compared to the gold standard methods, these differences were not significant. However, six patients （27.3%） were positive, and 16 （72.7%） were negative by the simple H pylori stool antigen cassette test. The sensitivity, specificity, positive and negative predictive values were 33%, 86%, 83% and 38%, respectively. Compared to the gold standard methods, the simple H pylori stool antigen cassette test results were significantly different （P = 0.012）. CONCLUSION： Rapid STRIP!HpSA test could be used as a routine diagnostic tool in the microbiology laboratory for assessing clinical significance and eradication control of H pylori in upper gastrointestinal system bleeding patients.
文摘Stool antigen tests(SATs)are noninvasive diagnostic modules for Helicobacter pylori(H.pylori)infection.Two types of SATs exist for the diagnosis of H.pylori infection,one based on enzyme immunoassay(EIA)and another on immunochromatography(ICA).SATs do not require expensive chemical agents or specified equipment;hence,they are less expensive compared with the urea breath test.Both European and Japanese guidelines have shown that EIA-based SATs using monoclonal antibodies are useful for primary diagnosis as well as for the assessment of eradication therapy.ICA-based tests do not require particular equipment and are therefore useful in developing countries.SATs are also useful for the diagnosis of H.pylori infection in children and post gastric surgery patients.SATs performed via EIA can assess H.pylori infection in a large number of subjects,almost as well as serology.Thus,SATs would be useful or detecting current infection in such a survey to identify and eradicate H.pylori infection.The accuracy of SATs is lower when the stool samples are unformed or watery,because H.pylorispecific antigens in the stool samples are diluted.Temperature and the interval between stool sample collection and measurement also affect the results of SATs.The choice of test kit depends on the sensitivity and specificity in each region and the circumstances of each patient.
文摘AIM: To investigate the effects of proton pump inhibitor (PPI) treatment on stool antigen test using the TestMate pylori enzyme immunoassay. METHODS: This study assessed 28 patients [16 men and 12 women; mean age (63.1 ± 5.9) years; range, 25-84 years] who underwent stool antigen test and urea breath test (UBT) before and after PPI administration. RESULTS: Using the UBT as the standard, the sensitivity, specif icity and agreement of the stool antigen test in all 28 patients were 95.2%, 71.4%, and 89.3%, respectively, before PPI administration, and 88.9%, 90.9%, and 89.3%, respectively, after PPI treatment. Mean UBT values were 23.98% ± 5.33% before and 16.19% ± 4.75% after PPI treatment and, in 15 patients treated for ≥ 4 wk, were signif icantly lower after than before 4 wk of PPI treatment (12.58% ± 4.49% vs 24.53% ± 8.53%, P = 0.048). The mean optical density (A450/630) ratios on the stool antigen test were 1.16 ± 0.20 before and 1.17 ± 0.24 after PPI treatment (P = 0.989), and were 1.02 ± 0.26 and 0.69 ± 0.28, respectively, in the group treated for > 4 wk (P = 0.099).
文摘AIM： To evaluate the agreement between a mAb-based stool test （HP STAR） and the urea breath test （UBT） in monitoring （H pylon） infection after eradication therapy. METHODS： Patients with discordant results on UBT and Hp STAR underwent endoscopy with biopsies for rapid urease test, culture, and histology to confirm H pylori status. RESULTS： Among 250 patients （50±14 years）, 240 （96.0%） had concordant UBT and Hp STAR tests with a significant correlation between DOB and A values （R = 0.87; P〈0.0001）. The remaining 10 （4.0%） patients had discordant tests （positive Hp STAR and negative UBT） with the Hp STAR inaccurate in five cases （false positive） and UBT inaccurate in the other five cases （false negative）. The “maximal expected” sensitivity, specificity, ＋PV, -PV, ＋LR, and -LR were 91%, 100%, 100%, 97.4%, ∞, and 8.2 respectively, for the UBT, and 100%, 97.4%, 91%, 100%, 38.8, and 0, respectively, for the Hp STAR. Overall accuracy for both tests was 98%. CONCLUSION： Both the UBT and the Hp StAR are equally accurate in monitoring H pylori infection. Nowadays, the choice of the “best” non-invasive H pylori test in the post-treatment setting should be done not only in terms of diagnostic accuracy but also in view of cost and local facilities.
文摘Introduction: Helicobacter pylori (H. pylori) is an important bacterial pathogen, predominantly in undeveloped countries and regions. We conducted this study to investigate the presence of H. pylori antigen in the stool specimens of children, in Tekirdag, Turkey. Material and Methods: Stool specimens of 1441 children aging between 0 month to 15 years, with the complaints of abdominal pain, anemia, gastroenteritis, nausea and vomiting were included in the study. The subjects were divided into three groups based on their ages: Group A (0 month - 5 years), Group B (6 - 10 years) and Group C (11 - 15 years). All specimens were tested for H. pylori antigen with HP Ag (DIA.PRO, Diagnostic Bioprobes, Italy). Results were evaluated statistically. Results: The median age of children with H. pylori positive samples was 6.6 ± 4.1 and 47.9% were girls. Overall positivity of H. pylori stool antigen was 6.6%. Positivity rates due to ages in Groups A, B and C were: 8.9%, 5.8%,? 5.2% respectively (x2 = 9.3, p = 0.01). No difference was observed due to gender (x2 = 0.17, p = 0.68). Conclusion: Higher antigen positivity obtained in 0 - 5 years group, indicates the risk of acquiring the infection in early years of life. Preventive measures for the development of H. pylori infection gain importance, especially in developing countries.
文摘BACKGROUND Standard triple therapy is an effective treatment for eradicating Helicobacter pylori infection,but it is encountered with drug resistance.The stool antigen test is a cost-effective and easy-to-perform test to confirm the eradication of H.pylori,4-8 weeks post-therapy,with 86%sensitivity and 92%specificity.AIM To assess the H.pylori eradication rate of standard triple therapy and factors affecting the eradication rate.METHODS We conducted a prospective,multicenter follow-up study in Addis Ababa,Ethiopia,at selected healthcare facilities among dyspeptic patients with positive stool H.pylori antigen tests from June 1,2023 to October 30,2023 to assess the H.pylori eradication rate.After completing the standard triple therapy,the eradication was confirmed using a stool antigen test 4 weeks later.The data were analyzed using bivariate and multivariate logistic regression methods.RESULTS The H.pylori eradication rate was 85.4%.Patients with a previous diagnosis of H.pylori infection,smokers,and local alcohol consumption were associated with a lower H.pylori eradication rate,with adjusted odds ratio(AORs)of 0.159[95%confidence interval(CI):0.050-0.511],0.206(95%CI:0.052-0.822),and 0.228(95%CI:0.052-0.997),respectively.Patients with complete symptom resolution were 5.383 times more likely to achieve eradication than patients without symptom improvement,AOR=5.383,95%CI:1.74-21.089.CONCLUSION H.pylori eradication rate was lower than expected.Post-treatment testing is crucial to confirm eradication and guide further management,such as susceptibility testing.
文摘Considering the recommended indications for Helicobacter pylori(H.pylori)eradication therapy and the broad spectrum of available diagnostic methods,a reliable diagnosis is mandatory both before and after eradication therapy.Only highly accurate tests should be used in clinical practice,and the sensitivity and specificity of an adequate test should exceed 90%.The choice of tests should take into account clinical circumstances,the likelihood ratio of positive and negative tests,the cost-effectiveness of the testing strategy and the availability of the tests.This review concerns some of the most recent developments in diagnostic methods of H.pylori infection,namely the contribution of novel endoscopic evaluation methodologies for the diagnosis of H.pylori infection,such as magnifying endoscopy techniques and chromoendoscopy.In addition,the diagnostic contribution of histology and the urea breath test was explored recently in specific clinical settings and patient groups.Recent studies recommend enhancing the number of biopsy fragments for the rapid urease test.Bacterial culture from the gastric biopsy is the gold standard technique,and is recommended for antibiotic susceptibility test.Serology is used for initial screening and the stool antigen test is particularly used when the urea breath test is not available,while molecular methods have gained attention mostly for detecting antibiotic resistance.
