scholarly journals Performance of RoutineHelicobacter pyloriInvasive Tests in Patients with Dyspepsia

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Hsi-Chang Lee ◽  
Ting-Chang Huang ◽  
Chin-Lin Lin ◽  
Kuan-Yang Chen ◽  
Chung-Kwe Wang ◽  
...  

Background. This study was designed to compare the accuracy of three different invasive methods for the detection ofHelicobacter pylori (H. pylori)infection in patients with dyspepsia. These tests included culture, histology, and the rapid urease test (CLO test).Methods.H. pyloriinfection was diagnosed prospectively in 246 untreated dyspeptic patients who underwent upper gastrointestinal endoscopy. The gold standard forH. pyloriinfection was based on a positive culture or both a positive histological examination and a CLO test.Results.H. pyloriwas diagnosed in 33.3% of the patients. The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were as follows: histology from the antrum (95.12; 95.12; 90.7; 97.5; 95.12%); histology from the antrum and corpus (95.12; 95.12; 90.7; 97.5; 95.12%); histology from the corpus (76.83; 96.95; 92.65; 89.33; 90.24%); culture (91.46; 100; 100; 95.91; 97.15%); a CLO test from the antrum and corpus (85.59; 100; 100; 93.71; 95.52%); a CLO test from the antrum (64.63; 100; 100; 84.97; 88.21%); a CLO test from the corpus (69.51; 100; 100; 96.77; 89.83%), respectively.Conclusions. Antral biopsy histology and culture are the best methods for the diagnosis ofH. pyloriinfection in our cohort of patients with dyspepsia.

Author(s):  
Mariana E. Maioli ◽  
Raquel F. N. Frange ◽  
Cintia M. C. Grion ◽  
Vinicius D. A. Delfino

Abstract Introduction: Treatment for Helicobacter pylori (H. pylori) infection is recommended in transplant candidates due to the association between this infection and gastrointestinal disorders, which could significantly increase morbidity after renal transplantation with the use of immunosuppression. The objective of this study was to analyze the rate of eradication of H. pylori after antimicrobial treatment in chronic kidney disease patients who are candidates for kidney transplantation. Methods: A multicenter prospective cohort study was conducted. All adult chronic kidney disease patients seen at our institution were included. In the pre-transplantation evaluation, 83 patients underwent an upper gastrointestinal endoscopy with 2 diagnostic methods to detect H. pylori: histology and the rapid urease test. In total, 33 patients with H. pylori infection received treatment with 20 mg omeprazole, 500 mg amoxicillin, and 500 mg clarithromycin once daily for 14 days. Another upper gastrointestinal endoscopy was performed 8 to 12 weeks after the end of treatment to check for healing. Results: The study showed a prevalence of H. pylori in 51 (61.4%) patients. Histology was positive in 50 (98%) patients and the rapid urease test was positive in 31 (60.8%). The infection eradication rate was 48.5% (16 patients). Conclusions: There was a high prevalence rate of H. pylori and a low eradication rate after the long-term antimicrobial triple scheme used. The association of the rapid urease test with gastric mucosa histology did not increase the detection rate of H. pylori.


1970 ◽  
Vol 4 (1) ◽  
pp. 14-17 ◽  
Author(s):  
Md Din-ul Islam ◽  
Sufi HZ Rahman ◽  
SM Shamsuzzaman ◽  
Naima Muazzaman ◽  
Nasim Ahmed ◽  
...  

The present study was conducted in the department of Microbiology, Dhaka Medical College, Dhaka during the period of January, 2007 to December, 2007. Urine samples were collected from 86 dyspeptic patients undergoing upper Gastrointestinal Tract (GIT) endoscopy to determine anti-H. pylori IgG antibody by an ELISA method. Gastric biopsy tissues were tested for culture, rapid urease test and H&E/Giemsa stain. Out of 86 endoscopic biopsy specimens, 45 (52.33%) were culture positive, 63 (73.26%) were rapid urease test positive and 64 (74.42%) were H&E/Giemsa stained positive for H. pylori. According to operational standard definition, among the 86 study population, 66 (76.74%) were H. pylori infected, 16 (18.60%) were uninfected and 4 (4.65%) were indeterminate. Among 66 H. pylori infected cases, 63 (95.45%) were urine ELISA positive and among 16 uninfected cases 3 (18.75%) were urine ELISA positive. Out of 86 study population, 66 (76.74%) were urine ELISA positive. The sensitivity, specificity, PPV, NPP and accuracy of urine ELISA were 95.45%, 81.25%, 95.45%, 81.25% and 92.68% respectively. The result of the study shows that H. pylori infection can be rapidly and reliably diagnosed by detecting anti-H. pylori IgG from urine. Key words: H. pylori; ELISA; GIT; IgG. DOI: http://dx.doi.org/10.3329/bjmm.v4i1.8463 BJMM 2011; 4(1): 14-17


2019 ◽  
Vol 13 (08) ◽  
pp. 720-726
Author(s):  
Diana F Rojas-Rengifo ◽  
Belen Mendoza ◽  
Carlos Jaramillo ◽  
Paula A Rodríguez-Urrego ◽  
José F Vera-Chamorro ◽  
...  

Introduction: The presence of H. pylori in the stomach is associated with gastric pathologies. However, its diagnosis through culture methods is challenging because of its complex nutritional requirements and microaerophilic conditions for optimal growth. The preferred method for rapid diagnosis of H. pylori is the Rapid Urease Test (RUT) from human biopsies, which relies on the high activity of the urease enzyme present in H. pylori. However, RUT cannot say much more information about H. pylori. This makes evident the need for bacterial culture to know essential information such as the strain type, the kind of infection present and the bacteria’s antibiotic susceptibility. Methodology: Gastric biopsies from 347 patients were used for H. pylori isolation. We correlated the culture results with the RUT and histological grading used at Hospital Universitario Fundación SantaFe de Bogotá (HU-FSFB), Colombia. The concordance between techniques was determined by the Cohen’s Kappa coefficient (K). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were also calculated. Results: The culture standardization was successful, and it could be applied for diagnosis in the clinical practice. H. pylori was positive by culture in 88 (26.34%) patients. The concordance of RUT and culture was strong (K= 0.805), and between histology and culture was moderate (K= 0.763) as well as for the gold standard defined and culture (K= 0.80). Conclusions: We present evidence that RUT and histological methods will be better interpreted for diagnosis of H. pylori if combined with bacterial isolation in cholesterol enriched culture.


2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Antoine Abou Rached ◽  
Jowana Saba ◽  
Cesar Yaghi ◽  
Joyce Sanyour ◽  
Ahmad El Hajjar ◽  
...  

Helicobacter pylori (H. pylori) can cause a wide variety of illnesses such as peptic ulcer disease, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. The diagnosis and eradication of H. pylori are crucial. The diagnosis of H. pylori is usually based on the rapid urease test (RUT) and gastric antral biopsy for histology. The aim of this study is to evaluate the numbers of needed biopsies and their location (antrum/fundus) to obtain optimal result for the diagnosis of H. pylori. Three hundred fifty consecutive patients were recruited, 210 fulfill the inclusion criteria and had nine gastric biopsies for the detection of H. pylori infection: two antral for the first RUT (RUT1), one antral and one fundic for the second (RUT2), one antral for the third (RUT3) and two antral with two fundic for histology (HES, Giemsa, PAS). The reading of the 3 types of RUT was performed at 1 hour, 3 hours and 24 hours and biopsies were read by two experienced pathologists not informed about the result of RUT. Results of RUT were considered positive if H. pylori was found on histology of at least one biopsy. The RUT1 at 1h, 3h and 24h has a sensitivity of 72%, 82% and 89% and a specificity of 100%, 99% and 87% respectively. The positive predictive value (PPV) was 100%, 99% and 85% respectively and the negative predictive value (NPV) of 81%, 87% and 90%. The RUT2 at 1h, 3h and 24h, respectively, had a sensitivity of 86%, 87% and 91% and a specificity of 99%, 97% and 90%. The PPV was 99%, 96% and 88% and NPV of 89%, 90%, 94%. The RUT3 at 1h, 3h and 24h, respectively, had a sensitivity of 70%, 74% and 84% and a specificity of 99%, 99% and 94%. The PPV was 99%, 99% and 92% and NPV of 79%, 81% and 87%. The best sensitivity and specificity were obtained for RUT1 read at 3h, for RUT2 read 1h and 3h, and the RUT3 read at 24h.This study demonstrates that the best sensitivity and specificity of rapid test for urease is obtained when fundic plus antral biopsy specimens are used with a reading time at 3 hours.


Author(s):  
Hasan Maulahela ◽  
Ari Fahrial Syam ◽  
Murdani Abdullah

Background: Helicobacter pylori is one of the most important infectious agents in the world. These bacteria infect 50% of the world population. Gastritis due to H. Pylori has been associated with the incidence of peptic ulcer, B cell primary lymphoma in the stomach, and gastric carcinoma. In dyspepsia, eradication of H. Pylori helps symptoms improvement and treatment cost efficiency. This study aimed to evaluate urease test in diagnosing H. Pylori infection in dyspepsia patients. It is expected that we could obtain a scientific evidence which can become the basis of routine use of urease examination in diagnosing H. Pylori  infection.Method: This study used diagnostic study design. This study was performed in adult dyspepsia patients who underwent endoscopy examination in Gastrointestinal Endoscopy Centre Cipto Mangunkusumo General Hospital in January – November 2018. One biopsy sample was intended for rapid urease test using Helicotec which was performed according to the standard procedure and was interpreted 2 hours later. Biopsy for histopathological examination was preserved in formalin solution and sent to Histopathology Department for analysis and identification of H. Pylori bacteria. Results: Prevalence of H. pylori infection based on histopathology examination was 7.2%. From seven positive results in histopathology examination, four samples were Helocitec positive. The sensitivity and specificity of Helicotec was 57.1% and 98.9%. The positive predictive value and negative predictive value were 80% and 96.7%. Conclusion: Rapid urease examination using Helicotec is one of H. pylori diagnostic tools that is good enough to diagnose faster and cheaper. Interpretation of rapid urease test also need to consider clinical condition of patients who are tested.


2019 ◽  
Vol 12 (11) ◽  
pp. e230870
Author(s):  
Katsunobu Yoshioka ◽  
Masanori Kishibuchi ◽  
Ko Takada

An 85-year-old woman was admitted to our hospital because of progressive hypoproteinemia and generalised oedema. Technetium-99m human albumin scintigraphy revealed protein leakage in the gastrointestinal tract. Upper gastrointestinal endoscopy revealed small whitish nodules from the gastric body up to the duodenal bulb. The urease test for Helicobacter pylori infection was positive. We diagnosed her as having protein-losing gastroenteropathy (PLGE) caused by H. pylori infection. The patient’s hypoproteinemia and clinical symptoms promptly resolved after H. pylori eradication. Our results suggest that a trial of H. pylori eradication is warranted in patients with PLGE, even if endoscopy reveals neither giant rugal folds, erosion of the mucosa, nor polyposis, which are previously reported characteristic endoscopic findings of PLGE.


2015 ◽  
Vol 1 (2) ◽  
pp. 11-14
Author(s):  
Yuba Raj Sharma ◽  
Amrita Wagley ◽  
Sunil Singh

Introductions: Helicobacter pylori is one of the common and medically prominent infections worldwide and an established etiological factor for peptic ulcer disease. This study was conducted to compare the results of two types of Rapid Urease Tests (RUT) for H. pylori infection.Methods: This study was conducted in patients with gastro duodenal diseases visiting Kantipur Hospital from June to August 2010. Antral biopsies were collected from sixty patients visiting endoscopy unit. The diagnosis was of H. pylori infection carried out using two types of rapid urease tests (commercial and homemade) as well as Histopathology.Results: H. pylori infection was detected in 34 (56.67%) of 60 by histological test, 24 (40%) by homemade kit method and 28 (46.67%) by commercial RUT method. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for RUT (commercial kit) considering histology as gold standard were 76.74%, 92.31%, 92.85% and 75% respectively. The sensitivity, specificity, PPV and NPV for RUT (homemade kit) were 58.82%, 84.62%, 83.3% and 61.11% respectively.Conclusions: Homemade rapid urease test was sensitive and specific for detection of H. pylori infection than commercial test.


2009 ◽  
Vol 35 (1) ◽  
pp. 7-10 ◽  
Author(s):  
M.A. Majid ◽  
T.I.M.A. Faruq ◽  
A.B.M. Bayezid Hossain

This is a cross-sectional study on 140 gastric neoplasm subjects diagnosed by upper gastrointestinal endoscopy. The commonest site of cancer was the antrum of stomach (52.86%), followed by the antrum and body (32.86%) and only body region (12.14%). Histology revealed adenocarcinoma in all patients. The associations of Helicobacter pylori with gastric cancer were studied by rapid urease test, serology and histology by Giemsa stain. The positivity of H. pylori determined by serology in 70 patients (50%) was significantly higher than those determined by histology 22 patients (15.71%). No significant association between H. pylori infection and gastric cancer was observed.Keywords: Gastric cancer; Helicobacter pylori; InfectionOnline: 20 May 2009DOI: 10.3329/bmrcb.v35i1.2315Bangladesh Med Res Counc Bull 2009; 35: 7-10


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Onyedika Godfrey Okoye ◽  
Oluwole Olayemi Olaomi ◽  
Alexander M.E. Nwofor ◽  
Paul Jibrin ◽  
Cephas Shallangwa Batta ◽  
...  

Background. Peptic ulcer disease (PUD) remains one of the most prevalent gastrointestinal diseases and has been linked to Helicobacter pylori (H. pylori) infection. This condition may be suspected on clinical grounds, but diagnosis is established using upper gastrointestinal endoscopy. Aims. To determine the correlation between the endoscopic and pathological findings among suspected PUD patients who have been referred for diagnostic upper gastrointestinal endoscopy in National Hospital Abuja. Methods. This is a hospital-based prospective study conducted among suspected PUD patients at National Hospital Abuja over a one-year period. Clinical, endoscopic, and histological findings were ascertained and documented. Data obtained were analyzed using SPSS version 21.0. Tests of significance were done using the chi-square test and Student t -test at 95% confidence intervals. Results. One hundred and thirty-two patients were included in the study. The ages ranged from 15 to 87 years, mean age 43.30 ± 11.94 years. Seventy-seven (58.3%) patients had abnormal endoscopic findings, of whom 37 (28.0%) had PUD. Prevalence of H. pylori infection was 42.2% and was found in 81.1% of PUD patients. H. pylori was significantly associated with confirmed PUD ( p < 0.001 ) and abnormal endoscopic findings ( p < 0.001 ). No association was found between normal endoscopic findings and histological findings ( p = 0.924 ). Conclusion. There is a poor correlation between clinical and endoscopic diagnoses of PUD. H. pylori was found to be significantly associated with PUD and abnormal endoscopic findings. Endoscopic facilities should therefore be made available and accessible for proper PUD diagnosis. Empirical treatment of H. pylori in patients with diagnosed PUD is strongly recommended.


2016 ◽  
Vol 64 (2) ◽  
pp. 388-391 ◽  
Author(s):  
María José Ramírez-Lázaro ◽  
Josep Lite ◽  
Sergio Lario ◽  
Pepa Pérez-Jové ◽  
Antònia Montserrat ◽  
...  

Laboratory-based chemiluminescence immunoassays (CLIA) are widely used in clinical laboratories. Some years ago, a CLIA test was developed for the detection of Helicobacter pylori in stool samples, known as LIAISON H. pylori SA, but little information on its use has been reported. To evaluate the accuracy of the LIAISON H. pylori SA assay for diagnosing H. pylori infection prior to eradication treatment. Diagnostic reliability was evaluated in 252 untreated consecutive patients with dyspepsia. The gold standard for diagnosing H. pylori infection was defined as the concordance of the rapid urease test (RUT), histopathology and urea breath test (UBT). The CLIA assay was performed according to the manufacturer's instructions. Sensitivity, specificity, positive and negative predictive values, and 95% CIs were calculated. According to the gold standard selected, 121 patients were positive for H. pylori infection and 131 negative. LIAISON H. pylori SA had a sensitivity of 90.1% and a specificity of 92.4%, with positive and negative predictive values of 91.6% and 90.1%, respectively. The accuracy of the LIAISON H. pylori SA chemiluminescent diagnostic assay seems comparable to that of ELISA or the best-performing LFIAs. Its sensitivity and specificity, however, seem slightly lower than those of histology, RUT or UBT. The advantages of the assay are that it is cheap, automated, and minimally labor-intensive.


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