Non-invasive diagnosis of Helicobacter pylori infection: simplified 13C-urea breath test, stool antigen testing, or DNA PCR in human feces in a clinical laboratory setting?

Clin Biochem. 2004 Apr;37(4):261-7. doi: 10.1016/j.clinbiochem.2003.12.004.

Abstract

Objectives: (1) To compare two stool antigen EIAs (HpSA, FemtoLab) and PCR of ureaseA and cagA in feces, with (13)C-urea breath test (UBT). (2) To ascertain whether a simplified UBT (breath collection time = 10 min) is as reliable as the standard assay (30 min).

Design and methods: Helicobacter pylori status was recorded in Group 1 (n = 187) by UBT, H. pylori stool antigen, ureA and cagA PCR in feces. UBT with 10, 20 and 30 min sampling was performed in Group 2 patients (n = 283).

Results: The sensitivity and specificity of HpSA, FemtoLab, and ureA were 67% and 99%, 90% and 96%, 35% and 98%, respectively. cagA results were positive in 16/48 H. pylori-positive, and in 5/100 H. pylori-negative patients. The results of UBT with a 10- and 30-min sampling strictly overlapped.

Conclusion: UBT with 10 min breath collection and FemtoLab stool antigen assay are the most reliable non-invasive tests to diagnose H. pylori infection.

MeSH terms

  • Adult
  • Aged
  • Antigens, Bacterial / analysis*
  • Antigens, Bacterial / genetics
  • Antigens, Bacterial / immunology
  • Bacterial Proteins / genetics
  • Breath Tests / methods*
  • Carbon Isotopes
  • Clinical Chemistry Tests / methods*
  • DNA, Bacterial / analysis*
  • DNA, Bacterial / genetics
  • Feces / microbiology*
  • Female
  • Helicobacter Infections / diagnosis*
  • Helicobacter Infections / immunology
  • Helicobacter Infections / microbiology
  • Helicobacter pylori / enzymology
  • Helicobacter pylori / genetics
  • Helicobacter pylori / isolation & purification
  • Humans
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Sensitivity and Specificity
  • Urea*
  • Urease / genetics

Substances

  • Antigens, Bacterial
  • Bacterial Proteins
  • Carbon Isotopes
  • DNA, Bacterial
  • cagA protein, Helicobacter pylori
  • Urea
  • Urease