Evaluation of Helicobacter pylori stool antigen test in comparison with conventional methods in detection of helicobacter pylori infection in dyspepsia patients
Keywords:
H pylori infection, Helicobacter pylori stool antigen test (HpSA), Rapid urease test (RUT)
Abstract
Background: Helicobacter pylori colonize the human stomach and is associated with gastritis, gastric and duodenal ulcers, gastric adenocarcinoma and mucosa associated lymphoid tissue lymphoma. Owing to its momentous pathogenic role, the diagnosis of H pylori infection remains a subject of interest. Helicobacter can be detected by invasive and non invasive methods.
Aim: The purpose of this study was to evaluate the accuracy of stool antigen test as a non invasive method for the diagnosis of H pylori infection.
Materials and Method: A prospective study was conducted in a tertiary medical college hospital. Patients presenting with dyspeptic symptoms were subjected to endoscopy and investigated for H pylori infection through rapid urease test, histopathology and culture. Stool samples were also collected from these patients and tested for H pylori infection by a rapid Hpylori Stool Antigen test. H pylori status was defined as positive when both rapid urease test (RUT) and histopathology were positive or culture alone was positive for biopsy based invasive methods. Similarly a positive rapid HpSA test also indicates H pylori infection.
Results: Of the 100 patients tested, 63 were H pylori infected by the endoscopy based invasive methods, and 54 by the non-invasive rapid HpSA test. The sensitivity, specificity and accuracy of H pylori stool antigen test were 85.7%, 88% and 91% respectively.
Conclusion: The rapid HpSA test could be used as a noninvasive diagnostictest for H pylori infection.
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References
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26. Islam S, Weilert F, Babington R, et al. Stool antigen testing for the diagnosis and confirmation of eradication of Helicobacter pylori infection: a prospective blinded trial. Intern Med J. 2005 Sep;35(9):526-9. DOI:10.1111/j.1445-5994.2005.00903.x
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2. Demiray E, Yilmaz O, Sarkis C, et al. Comparison of invasive methods and two different stool antigen tests for diagnosis of H pylori infection in patients with gastric bleeding. World J Gastroenterol. 2006 Jul 14;12(26):4206-10.[pubmed]
3. Allaker RP, Young KA, Hardie JM, Domizio P, Meadows NJ. Prevalence of Helicobacter pylori at oral and gastrointestinal sites in children: evidence for possible oral-to-oral transmission. J Med Microbiol 2002;51(4) :312-317.
4. Atherton Jc, Blaser Mj. Helicobacter pylori infections. In :Braunwold E, Fauci FC, Kasper DL, Hauser SL, Congo. DL, Jameson JL, editors Harrison’s principles of internal medicine 15th ed New York: MC Graw Hill: 2001; 960-3.
5. Versalovic J, Fox JG. Helicobacter. In ; Murray PR, Baron EJ, Pfeller MA, Fenoner FC, Yolken RH, editors. Manual of clinical microbiology. 7th ed. Washington DC: American Society for Microbiology, 1999; 727 – 38.
6. Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984 Jun 16;1(8390):1311-5.[pubmed]
7. Mishra KK, Srivastava S, Dwivedi PP, et al. UreC PCR based diagnosis of Helicobacter pylori infection and detection of cag A gene in gastric biopsies. ndian J Pathol Microbiol. 2002 Jan;45(1):31-7.[pubmed]
8. Blaser MJ. Helicobacter pylori and related organisms. In: Mandell GL, Bennett’s Principles and practice of infectious disease. 5th ed. Philadelphia: Churchill Livingstone. 2000; 2285-93.
9. Kabir S. Detection of Helicobacter pylori in faeces by culture, PCR and enzyme immunoassay. J Med Microbiol. 2001 Dec;50(12):1021-9. DOI:10.1099/0022-1317-50-12-1021. [pubmed]
10. Martin JJ, Anbumani N, Kalyani M, et al. H. pylori antigen detection in stool. Indian J Med Microbiol. 2006 Jan;24(1):79-80.[pubmed]
11. Vaira D, Malfertheiner P, Mégraud F, et al. Non-invasive antigen-based assay for assessing Helicobacter pylori eradication: a European multicenter study. The European Helicobacter pylori HpSA Study Group. Am J Gastroenterol. 2000 Apr;95(4):925-9. DOI:10.1111/j.1572-0241.2000.01931.x[pubmed]
12. Carroll IM, Ahmed N, Beesley SM, Khan AA, Ghousunnissa S, Morain CA, et al. Microevolution between paired antral and paired antrum and corpus Helicobacter pylori isolates recovered from individual patients. J Med Microbiol.2004; 1 July;53:669-77.
13. Kusters JG, van Vliet AH, Kuipers EJ. Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev. 2006 Jul;19(3):449-90. DOI:10.1128/CMR.00054-05.[pubmed]
14. Malfertheiner P, Megraud F, O'Morain C, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut. 2007 Jun;56(6):772-81. Epub 2006 Dec 14. DOI:10.1136/gut.2006.101634. [pubmed]
15. Syam AF, Rani AA, Abdullah M, Manan C, Makmun D, SimadibrataM,et al. Accuracy of Helicobacter pylori stool antigen for the detection of Helicobacter pylori infection in dyspeptic patients. World J Gastroenterol 2005; Jan 21, 11(3): 386-8.
16. Silva JM, Villares CA, Monteiro Mdo S, et al. Validation of a rapid stool antigen test for diagnosis of Helicobacter pylori infection. Rev Inst Med Trop Sao Paulo. 2010 May-Jun;52(3):125-8.[pubmed]
17. Marshall BJ, Plankey MW, Hoffman SR, et al. A 20-minute breath test for helicobacter pylori. Am J Gastroenterol. 1991 Apr;86(4):438-45.[pubmed]
18. Mattar R, Silva FM, Alexandrino AM, et al. Validation of 14C-urea breath test for diagnosis of Helicobacter pylori. Rev Inst Med Trop Sao Paulo. 1999 Jan-Feb;41(1):3-8.[pubmed]
19. Metz DC. Stool testing for Helicobacter pylori infection: yet another noninvasive alternative. Am J Gastroenterol. 2000 Feb;95(2):546-8.[pubmed]
20. Monteiro L, de Mascarel A, Sarrasqueta AM, et al. Diagnosis of Helicobacter pylori infection: noninvasive methods compared to invasive methods and evaluation of two new tests. Am J Gastroenterol. 2001 Feb;96(2):353-8. DOI:10.1111/j.1572-0241.2001.03518.x.[pubmed]
21. Li YH, Guo H, Zhang PB, et al. Clinical value of Helicobacter pylori stool antigen test, Immuno Card STAT HpSA, for detecting H pylori infection. World J Gastroenterol. 2004 Mar 15;10(6):913-4.
22. Choi J, Kim CH, Kim D, et al. Prospective evaluation of a new stool antigen test for the detection of Helicobacter pylori, in comparison with histology, rapid urease test, (13)C-urea breath test, and serology. J Gastroenterol Hepatol. 2011 Jun;26(6):1053-9. doi: 10.1111/j.1440-1746.2011.06705.x.[pubmed]
23. Pourlak T, Shokouhi B, Vahedi A. Role of Helicobacter Pylori stool antigen test in the diagnosis of Helicobacter Pylori infection. J Anal Res Clin Med 2017; 5(3):86-90.
24. Saha R, Roy P, Das S, Kaur N, et al. Application of a stool antigen test to evaluate the burden of Helicobacter pylori infection in dyspepsia patients. Indian J Pathol Microbiol. 2016 Jan-Mar;59(1):66-8. doi: 10.4103/0377-4929.174819.
25. Erzin Y, Altun S, Dobrucali A, et al. Comparison of two different stool antigen tests for the primary diagnosis of Helicobacter pylori infection in turkish patients with dyspepsia. Helicobacter. 2004 Dec;9(6):657-62. DOI:10.1111/j.1083-4389.2004.00280.x
26. Islam S, Weilert F, Babington R, et al. Stool antigen testing for the diagnosis and confirmation of eradication of Helicobacter pylori infection: a prospective blinded trial. Intern Med J. 2005 Sep;35(9):526-9. DOI:10.1111/j.1445-5994.2005.00903.x
27. Ito M, Tanaka S, Kim S, et al. A combination of the Helicobacter pylori stool antigen test and urea breath test is useful for clinical evaluation of eradication therapy: a multicenter study. J Gastroenterol Hepatol. 2005 Aug;20(8):1241-5. DOI:10.1111/j.1440-1746.2005.03928.x
CITATION
DOI: 10.17511/jopm.2018.i07.05
Published: 2018-11-30
How to Cite
Dr. Sai Priya B, Dr. Jagadevi, Dr. Suresh K, & Dr. M.G.Prakash. (2018). Evaluation of Helicobacter pylori stool antigen test in comparison with conventional methods in detection of helicobacter pylori infection in dyspepsia patients. Tropical Journal of Pathology and Microbiology, 4(7), 505-511. https://doi.org/10.17511/jopm.2018.i07.05
Section
Original Article
OAI - Open Archives Initiative
