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Wu H, Zhou Y, Huang Y. Accuracy of gastric nodule combined with rapid urease test prediction in diagnosing Helicobacter pylori infection in children. Eur J Clin Microbiol Infect Dis 2024; 43:481-487. [PMID: 38182925 DOI: 10.1007/s10096-023-04711-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/09/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND The diagnosis of Helicobacter pylori (H. pylori) infection in children remains challenging with the lack of a rapid, cost-effective, and highly accurate diagnostic method. Consequently, this study aimed to investigate the accuracy of the combination of gastric nodule and rapid urease test (RUT) as a diagnostic method for H. pylori infection in children. METHODS The study included participants who underwent a thorough examination, including gastroscopy, a 13C breath test, RUT, and pathological methylene blue staining, with the gold standard for diagnosing of H. pylori infection being a positive result from both pathological methylene blue staining and 13C breath test. The sensitivity, specificity, positive and negative predictive values, and accuracy of the diagnostic methods were calculated. RESULTS The accuracy of the different tests for H. pylori infection was evaluated in 2202 participants. A total of 730 (33.2%) children were diagnosed with H. pylori infection (pathological methylene blue staining and 13C breath test, both positive). Gastric nodule had a sensitivity of 87.1% and a specificity of 93.1%, whereas combining gastric nodule and RUT in parallel had the higher accuracy of 95.4%. The accuracy of gastric nodule diagnosis was higher in younger age groups and increased after excluding patients with a history of anti-H. pylori treatment. CONCLUSIONS The findings of this study suggest that gastric nodules, particularly when combined with RUT, can be a valuable predictor of H. pylori infection in children, offering a simple and feasible alternative to other invasive methods.
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Affiliation(s)
- Hailin Wu
- Children's Hospital of Fudan University, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Ying Zhou
- Children's Hospital of Fudan University, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
| | - Ying Huang
- Children's Hospital of Fudan University, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
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2
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Qi X, Kuan K, El Jabbour T, Lo Y, Liu Q, Fang Y. Retrospective analysis of discordant results between histology and other clinical diagnostic tests on helicobacter pylori infection. World J Gastrointest Endosc 2024; 16:64-71. [PMID: 38464820 PMCID: PMC10921152 DOI: 10.4253/wjge.v16.i2.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/24/2024] [Accepted: 01/11/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND A reliable test is essential for diagnosing Helicobacter pylori (H. pylori) infection, and crucial for managing H. pylori-related diseases. Serving as an excellent method for detecting H. pylori infection, histologic examination is a test that clinicians heavily rely on, especially when complemented with immunohistochemistry (IHC). Additionally, other diagnostic tests for H. pylori, such as the rapid urease test (CLO test) and stool antigen test (SA), are also highly sensitive and specific. Typically, the results of histology and other tests align with each other. However, on rare occasions, discrepancy between histopathology and other H. pylori diagnostic tests occurs. AIM To investigate the discordance between histology and other H. pylori tests, the underlying causes, and the impact on clinical management. METHODS Pathology reports of gastric biopsies were retrieved spanning August 2013 and July 2018. Reports were included in the study only if there were other H. pylori tests within seven days of the biopsy. These additional tests include CLO test, SA, and H. pylori culture. Concordance between histopathology and other tests was determined based on the consistency of results. In instances where histology results were negative while other tests were positive, the slides were retrieved for re-assessment, and the clinical chart was reviewed. RESULTS Of 1396 pathology reports were identified, each accompanied by one additional H. pylori test. The concordance rates in detecting H. pylori infection between biopsy and other tests did not exhibit significant differences based on the number of biopsy fragments. 117 discrepant cases were identified. Only 20 cases (9 with CLO test and 11 with SA) had negative biopsy but positive results in other tests. Four cases initially stained with Warthin-Starry turned out to be positive for H. pylori with subsequent IHC staining. Among the remaining 16 true discrepant cases, 10 patients were on proton pump inhibitors before the biopsy and/or other tests. Most patients underwent treatment, except for two who were untreated, and two patients who were lost to follow-up. CONCLUSION There are rare discrepant cases with negative biopsy but positive in SA or CLO test. Various factors may contribute to this inconsistency. Most patients in such cases had undergone treatment.
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Affiliation(s)
- Xiaohua Qi
- Department of Pathology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10467, United States
| | - Kevin Kuan
- Department of Pathology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10467, United States
| | - Tony El Jabbour
- Department of Pathology, Albert Einstein College of Medicine/Montefiore Medical Center, New York, NY 10467, United States
| | - Yungtai Lo
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, United States
| | - Qiang Liu
- Department of Pathology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10467, United States
| | - Yanan Fang
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY 10467, United States
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Al-Jumaily AY, Al-Haddad A, Al-Jubori SS. New strategies for Helicobacter pylori isolation and sequencing analysis for virulence genes contributing to its pathogenicity. Mol Biol Rep 2024; 51:95. [PMID: 38194007 DOI: 10.1007/s11033-023-09038-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/28/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Helicobacter pylori is a fastidious pathogen that is required a complicated medium for growth. Invading epithelial cells of the stomach. H. pylori virulence factors are classified by function, acidic resistivity, adhesion, chemotaxis and motility, molecular mimicry, immunological invasion and modulation, and toxins formation such as cytotoxin-associated genes A (cagA) and vacuolating cytotoxin A (vacA). This study aims to determine a simple and innovative technique to isolate H. pylori from gastric biopsies and assess pathogenicity by virulence factor gene detection. METHODS A total of 200 patients who were suspected of having H. pylori infection had two antral gastric biopsies undertaken. A rapid urease test (RUT) was used for one, and Brain Heart Infusion broth (BHI) was used to cultivate the other. The molecular study included diagnostics utilizing the 16sRNA housekeeping gene along with the identification of the virulence factors genes (cagA, cagT, and vacA) and sequencing, RESULT: Of the 200 antral gastric biopsies collected, 135 were positive rapid urease tests, and 17 H. pylori isolates were successfully obtained from 135 biopsies. The 16SrRNA as a housekeeping gene is confirmed, and about 53%, 70.5%, and 82.3% of the 17 isolates show carrying cagA, cagT, and vacA genes, respectively. All peptic ulcer isolates have the cagA gene, while Gastroesophageal Reflux Disease (GERD) and non-peptic ulcer disease (NPUD) isolates show the lack of the cagA gene. All bacteria, which were isolated from peptic ulcer, nodular gastritis, and gastritis patients, have a vacA gene. CONCLUSION The effective method for isolating H. pylori is centrifuging the transport broth after 24 h of incubation. The cagA toxin causes peptic ulcer while vacA toxin induces several histopathological changes in the stomach. Three virulence genes were present in all peptic ulcer-causing bacteria, while only one or none were present in the GERD and NPUD biopsy isolates.
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Affiliation(s)
- Asma Yahya Al-Jumaily
- Department of Biology, College of Science, Mustansiriyah University, Baghdad, 10046, Iraq
| | - Ahmed Al-Haddad
- Department of Physics, College of Science, Mustansiriyah University, Baghdad, 10046, Iraq
| | - Sawsan Sajid Al-Jubori
- Branch of Biotechnology, Department of Biology, College of Science, Mustansiriyah University, POX 10244, Baghdad, Iraq.
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Haider SI, Akhtar N, Saleem M, Ahmed S, Nadeem S, Amjad M, Ul Haq F. Diagnosis of ''Helicobacter pylori infection of the gastric biopsy'' by rapid urease test, histopathology and Raman spectroscopy. Diagn Microbiol Infect Dis 2024; 108:116129. [PMID: 37952308 DOI: 10.1016/j.diagmicrobio.2023.116129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/19/2023] [Accepted: 11/04/2023] [Indexed: 11/14/2023]
Abstract
This study aim to investigate the diagnostic potential of Raman spectroscopy in comparison with rapid urease test and histopathology in diagnosis of H. pylori infection. A comparative study was conducted at Pathology Laboratory and a total of 94 samples were collected from patients based on Rome IV criteria. Sensitivity, specificity and accuracy of histopathology, rapid urease test and for Raman spectroscopy were investigated. Rapid urease test showed 23 false negative results of H. pylori as compared to Raman spectroscopy and histopathology. We concluded that Raman spectroscopy showed sensitivity (94.5%), accuracy (94.0%) and specificity of (87.5%) in the diagnosis of H. pylori infection. However rapid urease test showed specificity of 92.5% while low sensitivity 75%, and 78% accuracy as compared to Raman spectroscopy and histopathology . This study illustrates the applicability of Raman spectroscopy as a potent innovative detection tool for the molecular detection of H. pylori infection in gastritis.
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Affiliation(s)
- Syed Iqbal Haider
- Department of Pathology, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Naeem Akhtar
- Department of Pathology, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Muhammad Saleem
- National Institute of Lasers and Optronics, of Pathology, CMH Lahore, Pakistan
| | - Sheraz Ahmed
- Islamic International Medical College, Rawalpindi, Punjab, Pakistan
| | - Shiza Nadeem
- Islamic International Medical College, Rawalpindi, Punjab, Pakistan
| | - Maham Amjad
- Department of Human Genetics and Molecular Biology, University of Health Sciences, Lahore, Pakistan
| | - Faiz Ul Haq
- Department of Microbiology, University of Health Sciences, Lahore, Pakistan.
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Vasapolli R, Ailloud F, Suerbaum S, Neumann J, Koch N, Macke L, Schirra J, Mayerle J, Malfertheiner P, Schulz C. Intraprocedural gastric juice analysis as compared to rapid urease test for real-time detection of Helicobacter pylori. World J Gastroenterol 2023; 29:1638-1647. [PMID: 36970593 PMCID: PMC10037247 DOI: 10.3748/wjg.v29.i10.1638] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/15/2023] [Accepted: 02/22/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Endofaster is an innovative technology that can be combined with upper gastrointestinal endoscopy (UGE) to perform gastric juice analysis and real-time detection of Helicobacter pylori (H. pylori).
AIM To assess the diagnostic performance of this technology and its impact on the management of H. pylori in the real-life clinical setting.
METHODS Patients undergoing routine UGE were prospectively recruited. Biopsies were taken to assess gastric histology according to the updated Sydney system and for rapid urease test (RUT). Gastric juice sampling and analysis was performed using the Endofaster, and the diagnosis of H. pylori was based on real-time ammonium measurements. Histological detection of H. pylori served as the diagnostic gold standard for comparing Endofaster-based H. pylori diagnosis with RUT-based H. pylori detection.
RESULTS A total of 198 patients were prospectively enrolled in an H. pylori diagnostic study by Endofaster-based gastric juice analysis (EGJA) during the UGE. Biopsies for RUT and histological assessment were performed on 161 patients (82 men and 79 women, mean age 54.8 ± 19.2 years). H. pylori infection was detected by histology in 47 (29.2%) patients. Overall, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value (NPV) for H. pylori diagnosis by EGJA were 91.5%, 93.0%, 92.6%, 84.3%, and 96.4%, respectively. In patients on treatment with proton pump inhibitors, diagnostic sensitivity was reduced by 27.3%, while specificity and NPV were unaffected. EGJA and RUT were comparable in diagnostic performance and highly concordant in H. pylori detection (κ-value = 0.85).
CONCLUSION Endofaster allows for rapid and highly accurate detection of H. pylori during gastroscopy. This may guide taking additional biopsies for antibiotic susceptibility testing during the same procedure and then selecting an individually tailored eradication regimen.
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Affiliation(s)
- Riccardo Vasapolli
- Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany
- Deutsches Zentrum für Infektionsforschung, Partner Site Munich, Munich 81377, Germany
| | - Florent Ailloud
- Max von Pettenkofer Institute, Faculty of Medicine, Ludwig-Maximilians University of Munich, Munich 80336, Germany
- National Reference Center for Helicobacter pylori, Munich 81377, Germany
| | - Sebastian Suerbaum
- Deutsches Zentrum für Infektionsforschung, Partner Site Munich, Munich 81377, Germany
- Max von Pettenkofer Institute, Faculty of Medicine, Ludwig-Maximilians University of Munich, Munich 80336, Germany
- National Reference Center for Helicobacter pylori, Munich 81377, Germany
| | - Jens Neumann
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University of Munich, Munich 81377, Germany
| | - Nadine Koch
- Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany
| | - Lukas Macke
- Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany
- Deutsches Zentrum für Infektionsforschung, Partner Site Munich, Munich 81377, Germany
| | - Jörg Schirra
- Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany
| | - Julia Mayerle
- Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany
| | - Peter Malfertheiner
- Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany
| | - Christian Schulz
- Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany
- Deutsches Zentrum für Infektionsforschung, Partner Site Munich, Munich 81377, Germany
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Vasapolli R, Ailloud F, Suerbaum S, Neumann J, Koch N, Macke L, Schirra J, Mayerle J, Malfertheiner P, Schulz C. Intraprocedural gastric juice analysis as compared to rapid urease test for real-time detection of Helicobacter pylori. World J Gastroenterol 2023; 29:1494-1503. [DOI: 10.3748/wjg.v29.i10.1494] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Endofaster is an innovative technology that can be combined with upper gastrointestinal endoscopy (UGE) to perform gastric juice analysis and real-time detection of Helicobacter pylori (H. pylori).
AIM To assess the diagnostic performance of this technology and its impact on the management of H. pylori in the real-life clinical setting.
METHODS Patients undergoing routine UGE were prospectively recruited. Biopsies were taken to assess gastric histology according to the updated Sydney system and for rapid urease test (RUT). Gastric juice sampling and analysis was performed using the Endofaster, and the diagnosis of H. pylori was based on real-time ammonium measurements. Histological detection of H. pylori served as the diagnostic gold standard for comparing Endofaster-based H. pylori diagnosis with RUT-based H. pylori detection.
RESULTS A total of 198 patients were prospectively enrolled in an H. pylori diagnostic study by Endofaster-based gastric juice analysis (EGJA) during the UGE. Biopsies for RUT and histological assessment were performed on 161 patients (82 men and 79 women, mean age 54.8 ± 19.2 years). H. pylori infection was detected by histology in 47 (29.2%) patients. Overall, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value (NPV) for H. pylori diagnosis by EGJA were 91.5%, 93.0%, 92.6%, 84.3%, and 96.4%, respectively. In patients on treatment with proton pump inhibitors, diagnostic sensitivity was reduced by 27.3%, while specificity and NPV were unaffected. EGJA and RUT were comparable in diagnostic performance and highly concordant in H. pylori detection (κ-value = 0.85).
CONCLUSION Endofaster allows for rapid and highly accurate detection of H. pylori during gastroscopy. This may guide taking additional biopsies for antibiotic susceptibility testing during the same procedure and then selecting an individually tailored eradication regimen.
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Affiliation(s)
- Riccardo Vasapolli
- Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany,Deutsches Zentrum für Infektionsforschung, Partner Site Munich, Munich 81377, Germany
| | - Florent Ailloud
- Max von Pettenkofer Institute, Faculty of Medicine, Ludwig-Maximilians University of Munich, Munich 80336, Germany,National Reference Center for Helicobacter pylori, Munich 81377, Germany
| | - Sebastian Suerbaum
- Deutsches Zentrum für Infektionsforschung, Partner Site Munich, Munich 81377, Germany,Max von Pettenkofer Institute, Faculty of Medicine, Ludwig-Maximilians University of Munich, Munich 80336, Germany,National Reference Center for Helicobacter pylori, Munich 81377, Germany
| | - Jens Neumann
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-University of Munich, Munich 81377, Germany
| | - Nadine Koch
- Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany
| | - Lukas Macke
- Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany,Deutsches Zentrum für Infektionsforschung, Partner Site Munich, Munich 81377, Germany
| | - Jörg Schirra
- Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany
| | - Julia Mayerle
- Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany
| | - Peter Malfertheiner
- Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany
| | - Christian Schulz
- Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany,Deutsches Zentrum für Infektionsforschung, Partner Site Munich, Munich 81377, Germany
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Noh JH, Ahn JY, Choi J, Park YS, Na HK, Lee JH, Jung KW, Kim DH, Choi KD, Song HJ, Lee GH, Jung HY, Kim JM. Real-Time Polymerase Chain Reaction for the Detection of Helicobacter pylori and Clarithromycin Resistance. Gut Liver 2022; 17:375-381. [PMID: 35854654 DOI: 10.5009/gnl220076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/30/2022] [Accepted: 04/14/2022] [Indexed: 11/04/2022] Open
Abstract
Background/Aims Real-time polymerase chain reaction (RT-PCR) is a fast and simple method for the simultaneous detection of clarithromycin (CLR) resistance and Helicobacter pylori. We evaluated the effectiveness of RT-PCR compared to that of the rapid urease test (RUT) and assessed its value in verifying CLR resistance. Methods A total of 70 specimens with confirmed H. pylori infection in culture were enrolled and analyzed in this prospective study. All specimens were subjected to RT-PCR assay using fluorescence melting peak signals to detect H. pylori infection and CLR resistances caused by either A2142G or A2143G mutations in the 23S ribosomal RNA gene (23S rRNA). The results were compared to those of RUT and antimicrobial susceptibility culturing tests to investigate the efficacy of RT-PCR. Results Among the 70 specimens analyzed, the positivity rate was 97.1% (68/70) with RT-PCR and 82.9% (58/70) with RUT. CLR resistance (minimum inhibitory concentration >1.0 μg/mL) was confirmed in 18.6% (13/70), and fluorescence melting curve analysis showed that 84.6% (11/13) had point mutations in 23S rRNA. Ten specimens had only A2143G mutation, and one specimen contained both A2142G and A2143G mutations. Conclusions RT-PCR assay was found to be more efficient than RUT in detecting H. pylori infection and could effectively verify CLR resistance compared to the antimicrobial susceptibility culturing test. Considering the high sensitivity and accessibility of RT-PCR method, it could be used to easily detect CLR-resistant H. pylori, thus helping clinicians select suitable treatment regimen and improve the eradication rate.
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Affiliation(s)
- Jin Hee Noh
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yong Ahn
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jene Choi
- Departments of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Soo Park
- Departments of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee Kyong Na
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Hoon Lee
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee Wook Jung
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Do Hoon Kim
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee Don Choi
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ho June Song
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gin Hyug Lee
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hwoon-Yong Jung
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Mogg Kim
- Department of Microbiology, Hanyang University College of Medicine, Seoul, Korea
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Senchukova MA, Tomchuk O, Shurygina EI. Helicobacter pylori in gastric cancer: Features of infection and their correlations with long-term results of treatment. World J Gastroenterol 2021; 27:6290-6305. [PMID: 34712033 PMCID: PMC8515796 DOI: 10.3748/wjg.v27.i37.6290] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/21/2021] [Accepted: 08/31/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) is a spiral-shaped bacterium responsible for the development of chronic gastritis, gastric ulcer, gastric cancer (GC), and MALT-lymphoma of the stomach. H. pylori can be present in the gastric mucosa (GM) in both spiral and coccoid forms. However, it is not known whether the severity of GM contamination by various vegetative forms of H. pylori is associated with clinical and morphological characteristics and long-term results of GC treatment.
AIM To establish the features of H. pylori infection in patients with GC and their correlations with clinical and morphological characteristics of diseases and long-term results of treatment.
METHODS Of 109 patients with GC were included in a prospective cohort study. H. pylori in the GM and tumor was determined by rapid urease test and by immunohistochemically using the antibody to H. pylori. The results obtained were compared with the clinical and morphological characteristics and prognosis of GC. Statistical analysis was performed using the Statistica 10.0 software.
RESULTS H. pylori was detected in the adjacent to the tumor GM in 84.5% of cases, of which a high degree of contamination was noted in 50.4% of the samples. Coccoid forms of H. pylori were detected in 93.4% of infected patients, and only coccoid-in 68.9%. It was found that a high degree of GM contamination by the coccoid forms of H. pylori was observed significantly more often in diffuse type of GC (P = 0.024), in poorly differentiated GC (P = 0.011), in stage T3-4 (P = 0.04) and in N1 (P = 0.011). In cases of moderate and marked concentrations of H. pylori in GM, a decrease in 10-year relapse free and overall survival from 55.6% to 26.3% was observed (P = 0.02 and P = 0.07, respectively). The relationship between the severity of the GM contamination by the spiral-shaped forms of H. pylori and the clinical and morphological characteristics and prognosis of GC was not revealed.
CONCLUSION The data obtained indicates that H. pylori may be associated not only with induction but also with the progression of GC.
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Affiliation(s)
- Marina A Senchukova
- Department of Oncology, Orenburg State Medical University, Orenburg 460000, Russia
| | - Olesya Tomchuk
- Department of Histology, Cytology, Embryology, Orenburg State Medical University, Orenburg 460000, Russia
| | - Elena I Shurygina
- Department of Pathology, Orenburg State Medical University, Orenburg 460000, Russia
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9
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Padole P, Ranjan P, Sachdeva M, Kumar M. Role of Helicobacter pylori eradication in patients with functional dyspepsia. Indian J Gastroenterol 2021; 40:492-501. [PMID: 34708338 DOI: 10.1007/s12664-021-01195-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/11/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Helicobacter pylori (H. pylori) is implicated in the pathogenesis of functional dyspepsia (FD). There is conflicting data regarding the benefit of H. pylori eradication for symptom relief in FD. AIMS To study the benefit of eradicating H. pylori in patients with FD as compared to standard medical treatment (SMT). Secondary aims were to find efficacy of H. pylori eradication therapy, recurrence of H. pylori after eradication, and predictors of efficacy. METHODS Consecutive adult patients of FD (ROME IV) with H. pylori infection presenting in the outpatient department of our hospital were enrolled. Patients with Global Overall Symptom (GOS) scale > 2 and H. pylori infection were included. Patients were randomized into two groups: group 1 received H. pylori eradication therapy and group 2 received SMT. Treatment success was defined as symptom relief (GOS score < 2 and reduction by at least 2 points at 6 months) and H. pylori eradication was defined as stool antigen negative at 4 weeks. RESULTS Of 329 participants with FD, 253 were H. pylori positive (rapid urease test and stool antigen test) (76.89%). After exclusions, 202 were randomized into two groups of 101 each. Thirty-two patients in group 1 and 31 in group 2 had treatment success (31.7% vs. 30.7%, p=1.000). The efficacy of H. pylori eradication therapy was 74.46% (70/94). H. pylori reinfection rate was 26.02% (19/73). CONCLUSIONS H. pylori eradication therapy does not provide additional benefit in symptom relief in patients with FD as compared with SMT. TRIAL REGISTRATION NCT04697641 (retrospectively registered on www.clinicaltrials.gov in January 2021).
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Affiliation(s)
- Prateek Padole
- Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences, Sir Ganga Ram Hospital, New Delhi , 110 060, India
| | - Piyush Ranjan
- Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences, Sir Ganga Ram Hospital, New Delhi , 110 060, India.
| | - Munish Sachdeva
- Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences, Sir Ganga Ram Hospital, New Delhi , 110 060, India
| | - Mandhir Kumar
- Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences, Sir Ganga Ram Hospital, New Delhi , 110 060, India
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10
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Penny Z, Reynolds IS, Buckley M, Martin ST. Rapid urease testing in isolation is inadequate during invasive testing for H. pylori. Ir J Med Sci 2021; 191:963-964. [PMID: 34053003 DOI: 10.1007/s11845-021-02670-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Zakya Penny
- Department of Surgery, St Michael's Hospital, Co Dublin, Dublin, Ireland
| | - Ian S Reynolds
- Department of Surgery, St Michael's Hospital, Co Dublin, Dublin, Ireland.
| | - Máire Buckley
- Department of Gastroenterology, St Michael's Hospital, Co Dublin, Dublin, Ireland
| | - Sean T Martin
- Department of Surgery, St Michael's Hospital, Co Dublin, Dublin, Ireland
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Kouitcheu Mabeku LB, Bello Epesse M, Fotsing S, Kamgang R, Tchidjo M. Stool Antigen Testing, a Reliable Noninvasive Method of Assessment of Helicobacter pylori Infection Among Patients with Gastro-duodenal Disorders in Cameroon. Dig Dis Sci 2021; 66:511-520. [PMID: 32350723 DOI: 10.1007/s10620-020-06219-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 03/18/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Several techniques such as invasive and noninvasive are used for the diagnosis of H. pylori infection. AIM The aim of this study was to compare the results of rapid urease test, stool antigen test and serology in diagnosing H. pylori infection in Cameroon. METHODS Hundred patients (66 women and 34 men) were enrolled. Each patient gave a written consent. The study was approved by the local Ethical Committee of Medical Sciences and the institutional review board. From each patient, blood, stool and gastric biopsies samples were collected for H. pylori detection using three methods: stool antigen test, serology and rapid urease test (RUT), taken as gold standard. Statistical analysis was performed using Graph pad Prism 7. RESULTS Helicobacter pylori infection was detected in 43%, 45% and 73% of patients based on the RUT, stool antigen test and serology, respectively. The difference was statistically significant between serology and RUT (P = 0.0026), but not between stool antigens test and RUT (P = 0.288). Taken RUT as gold standard, the sensitivity, specificity, positive and negative predictive values of stool antigens test and serology were 65.11, 70.17, 62.22 and 72.72%; 88.37, 40.35, 55.77 and 82.14%, respectively. The accuracy of stool antigen test and serology was 68 and 61%, respectively. CONCLUSIONS Our finding showed that stool antigen test can be used as a noninvasive method of assessment of H. pylori infection in our setting. Serological test can be used in screening; however, further diagnostic tests need to be carried out to confirm seropositive cases.
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Affiliation(s)
- Laure Brigitte Kouitcheu Mabeku
- Microbiology and Pharmacology Laboratory, Department of Biochemistry, Faculty of Science, University of Dschang, P. O. Box 67, Dschang, Cameroon.
| | - Mohamadou Bello Epesse
- Microbiology and Pharmacology Laboratory, Department of Biochemistry, Faculty of Science, University of Dschang, P. O. Box 67, Dschang, Cameroon
| | - Stephane Fotsing
- Gastroenterology Department, Laquintinie Hospital of Douala, P. O. Box 4035, Douala, Cameroon
| | - Roland Kamgang
- Gastroenterology Department, Polyclinique de Poitiers, P. O. Box 15422, Douala, Cameroon
| | - Magloire Tchidjo
- Gastroenterology Department, Polyclinique de Poitiers, P. O. Box 15422, Douala, Cameroon
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Dechant FX, Dechant R, Kandulski A, Selgrad M, Weber F, Reischl U, Wilczek W, Mueller M, Weigand K. Accuracy of Different Rapid Urease Tests in Comparison with Histopathology in Patients with Endoscopic Signs of Gastritis. Digestion 2020; 101:184-190. [PMID: 30820016 DOI: 10.1159/000497810] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 02/10/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIM According to several guidelines, both invasive and non-invasive tests can be used to detect Helicobacter pylori (H. pylori). Invasive methods include H. pylori culture, histological staining, rapid urease tests (RUTs) and PCR. Non-invasive methods include urease breath test, stool antigen and serum IgG testing. The aim of our study was to compare all commercially available RUTs and histology in Germany. MATERIAL AND METHODS One hundred fifty patients were enrolled in our study, irrespective of proton pump inhibitors (PPIs) or antibiotic use. If the results of RUTs and histology were diverging, real-time PCR to detect H. pylori DNA was undertaken. RESULTS We detected no differences in the sensitivity or specificity between the different RUTs. In PPI and/or antibiotic-treated patients, RUTs seemed to be more sensitive for the detection of H. pylori infection compared to histology. In addition to the cheaper price of RUTs, they are also quicker to process. We show that histological staining in patients with signs of gastritis is expensive and not necessary, if there are no additional histological questions besides H. pylori status. CONCLUSIONS In conclusion, we consider RUTs to be cheap and fast alternatives to histology in patients with endoscopic signs of gastritis, independently of whether PPIs or antibiotic are used. Histological evaluation is expensive, time consuming and may be unnecessary in some cases.
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Affiliation(s)
- Franz-Xaver Dechant
- Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Rebecca Dechant
- Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Arne Kandulski
- Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Michael Selgrad
- Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Florian Weber
- Department of Pathology, University of Regensburg, Regensburg, Germany
| | - Udo Reischl
- Department of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Wolf Wilczek
- Hospital Pharmacy, University Hospital Regensburg, Regensburg, Germany
| | - Martina Mueller
- Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Kilian Weigand
- Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany,
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Milani M, Moaddab Y, Sharifi Y. One piece biopsy for both rapid urease test and cultivation of Helicobacter pylori. J Microbiol Methods 2019; 164:105674. [PMID: 31348953 DOI: 10.1016/j.mimet.2019.105674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND & AIMS Increasing antibiotic resistance among Helicobacter pylori isolates and the unsuccessful attempts at eradication can impose many costs to both healthcare systems and patients. The present study intended to find a way from which H. pylori could be isolated from biopsies with less invasive procedures undertaken on infected patients. METHODS A biopsy specimen from each patient with gastric disorders was put into urea-containing agar. After two hours, the specimens were removed from agar and placed into tubes containing 1 ml 20% glucose solution. Then, the specimens were inoculated onto the Columbia agar and incubated under microaerophilic conditions. The grown colonies were identified as H.pylori based on the microbiology tests and PCR. RESULTS Overall, 449 biopsy specimens were collected from the patients. Of all biopsies, 219 (48.8%) revealed positive results in the rapid urease test. Using the aforementioned method, 158 (35.2%) culture positive biopsy specimens were obtained. CONCLUSION The researchers attempted to use one biopsy specimen for both rapid urease and culture tests. This method causes fewer injuries of gastric tissue and allows antimicrobial susceptibility testing and characterization in detail of the isolated organism.
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Affiliation(s)
- Morteza Milani
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Science, Tabriz, Iran; Department of Medical Nanotechnology, Faculty of Advanced Medical Science, Medical University of Tabriz, Tabriz, Iran
| | - Yaghuob Moaddab
- Liver and Gastrointestinal disease research center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yaeghob Sharifi
- Department of Microbiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran; Cellular and molecular research center, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
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Chen XY, Yu XB, Chen XQ, Chen Y, Liang W. Comparison of tests for detecting Helicobacter pylori in gastric biopsy. Shijie Huaren Xiaohua Zazhi 2018; 26:1499-1504. [DOI: 10.11569/wcjd.v26.i25.1499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To figure out a method to detect Helicobacter pylori (H. pylori) infection that is of high sensitivity and specificity as well as clinically easy-handling by comparing four common H. pylori detection methods.
METHODS Four hundred and ninety gastric mucosa biopsies were tested separately by the rapid urease test (RUT), fluorescence quantitative polymerase chain reaction (qPCR), methylene blue staining, and immunohis-tochemistry (IHC). Positive rates obtained by the different methods were analyzed by the χ2 test.
RESULTS The positive rates of H. pylori obtained by RUT, qPCR, methylene blue staining, and IHC were 18.98%, 63.88%, 32.04%, and 38.16%, respectively, which were statistically different (P < 0.005).
CONCLUSION IHC provides a visual scene for observers, and there is a sharp contrast for IHC images between H. pylori infected and surrounding areas. This feature can facilitate researchers to obtain morphological information with potential clinical value. Furthermore, IHC protocols are friendly to instruments and operators. Hence, we recommend that IHC be used to detect H. pylori in gastric biopsies for diagnosing H. pylori infection and determining H. pylori treatment.
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Affiliation(s)
- Xiao-Yan Chen
- Department of Pathology, Fujian Provincial Hospital, Fuzhou 350001, Fujian Province, China
| | - Xun-Bin Yu
- Department of Pathology, Fujian Provincial Hospital, Fuzhou 350001, Fujian Province, China
| | - Xiao-Qiong Chen
- Provincial Clinical Medical College, Fujian Medical University, Fuzhou 350001, Fujian Province, China
| | - Yong Chen
- Fuzhou Maixin Biotech Co., Ltd, Fuzhou 350001, Fujian Province, China
| | - Wei Liang
- Department of Digestive Endoscopy, Provincial Clinical Medical College, Fujian Medical University, Fujian Provincial Hospital, Fuzhou 350001, Fujian Province, China
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Ge YF, Guan X, Jiang XJ. Clinical significance of Helicobacter pylori in the grouth of ulcerative colitis. Shijie Huaren Xiaohua Zazhi 2018; 26:1071-1076. [DOI: 10.11569/wcjd.v26.i17.1071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the relationship between Helicobacter pylori (H. pylori) infection and ulcerative colitis (UC).
METHODS One hundred and forty-six patients with UC diagnosed by colonoscopy and pathological examination were selected as a UC group. In addition, 150 volunteers who had no obvious colonic lesions as detected by electronic colonoscopy were collected as a control group. Rapid urease test and histopathological biopsy were used to detect H. pylori infection.
RESULTS In UC Group, 146 cases, 27 positive, H. pylori infection positive rate of 18.49%, control group of 150 cases, 64 positive, H. pylori infection positive rate 42.67%, UC group is significantly lower than the control group, the difference is statistically significant (P < 0.05). According to lesion Range: Rectal Group 27 cases, 7 positive, H. pylori positive rate is 21.88%, left half colon group 48 cases, 9 cases positive, H. pylori positive rate is 18.75%, extensive colon group 66 cases, 11 cases positive, H. pylori positive rate is 16.67%. There was no statistically significant difference among the three groups (P > 0.05). Active period of UC patients in 117 cases (80.14%), remission period of UC patients in 29 cases. The positive rate of H. pylori infection was the highest in remission period (37.93%), the lowest rate of severe activity was (6.25%), the difference was obvious (P < 0.05).
CONCLUSION H. pylori infection may have a preventive effect on the grouth of UC, with the severity of the disease increasing, the H. pylori positive rate decreased. In addition, it will be very important to strengthen the follow-up compliance of UC patients.
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Affiliation(s)
- Yong-Fang Ge
- Department of Gastroenterology (Division II), Qingdao Municipal Hospital, Qingdao University Medical College, Qingdao 266000, Shandong Province, China
| | - Xin Guan
- Department of Gastroenterology (Division II), Qingdao Municipal Hospital, Qingdao University Medical College, Qingdao 266000, Shandong Province, China
| | - Xiang-Jun Jiang
- Department of Gastroenterology (Division II), Qingdao Municipal Hospital, Qingdao University Medical College, Qingdao 266000, Shandong Province, China
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Dahlén G, Hassan H, Blomqvist S, Carlén A. Rapid urease test (RUT) for evaluation of urease activity in oral bacteria in vitro and in supragingival dental plaque ex vivo. BMC Oral Health 2018; 18:89. [PMID: 29776416 PMCID: PMC5960132 DOI: 10.1186/s12903-018-0541-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 04/26/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Urease is an enzyme produced by plaque bacteria hydrolysing urea from saliva and gingival exudate into ammonia in order to regulate the pH in the dental biofilm. The aim of this study was to assess the urease activity among oral bacterial species by using the rapid urease test (RUT) in a micro-plate format and to examine whether this test could be used for measuring the urease activity in site-specific supragingival dental plaque samples ex vivo. METHODS The RUT test is based on 2% urea in peptone broth solution and with phenol red at pH 6.0. Oral bacterial species were tested for their urease activity using 100 μl of RUT test solution in the well of a micro-plate to which a 1 μl amount of cells collected after growth on blood agar plates or in broth, were added. The color change was determined after 15, 30 min, and 1 and 2 h. The reaction was graded in a 4-graded scale (none, weak, medium, strong). Ex vivo evaluation of dental plaque urease activity was tested in supragingival 1 μl plaque samples collected from 4 interproximal sites of front teeth and molars in 18 adult volunteers. The color reaction was read after 1 h in room temperature and scored as in the in vitro test. RESULTS The strongest activity was registered for Staphylococcus epidermidis, Helicobacter pylori, Campylobacter ureolyticus and some strains of Haemophilus parainfluenzae, while known ureolytic species such as Streptococcus salivarius and Actinomyces naeslundii showed a weaker, variable and strain-dependent activity. Temperature had minor influence on the RUT reaction. The interproximal supragingival dental plaque between the lower central incisors (site 31/41) showed significantly higher scores compared to between the upper central incisors (site 11/21), between the upper left first molar and second premolar (site 26/25) and between the lower right second premolar and molar (site 45/46). CONCLUSION The rapid urease test (RUT) in a micro-plate format can be used as a simple and rapid method to test urease activity in bacterial strains in vitro and as a chair-side method for testing urease activity in site-specific supragingival plaque samples ex vivo.
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Affiliation(s)
- Gunnar Dahlén
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Box 450, SE 40530 Gothenburg, Sweden
| | - Haidar Hassan
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Box 450, SE 40530 Gothenburg, Sweden
| | - Susanne Blomqvist
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Box 450, SE 40530 Gothenburg, Sweden
| | - Anette Carlén
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Box 450, SE 40530 Gothenburg, Sweden
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Mani S, Rekha A, Srinivasan MKR, Bhanumathy V. To Evaluate the Role of H. pylori in Patients with Chronic Recurrent Tonsillitis. Indian J Otolaryngol Head Neck Surg 2019; 71:254-8. [PMID: 31275840 DOI: 10.1007/s12070-018-1313-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 03/20/2018] [Indexed: 10/17/2022] Open
Abstract
The usual indication for surgical resection of tonsils is chronic recurrent tonsillitis. Literature also does not indicate the reason behind the fact that only part of the population suffers from recurrent chronic tonsillitis in spite being exposed to similar conditions. This was a prospective study, in which 50 tonsil biopsy samples obtained from chronic tonsillitis patients. Specimens were analysed with rapid urease broth test, HelicotecUT PLUS assay and Toluidine blue staining for presence of Helicobacter pylori. The age ranged from 4 to 34 years. The median age for patients with chronic recurrent tonsillitis was 9.5, 23 (46%) patients were male while 27 (54%) were female, presence of H. pylori by rapid urease broth test, HelicotecUT PLUS assay and Histopathology was 4%. Our analysis revealed that H. pylori did not significantly colonize the tonsils and does not play a role in the pathogenesis or development of chronic tonsillitis. The heterogeneity in study population and methodology may have contributed to the non significant results.
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Kohli S, Mahajan VK, Rana BS, Mehta KS, Raina RK, Chauhan PS, Sharma V, Rawat R. Clinicoepidemiologic Features of Chronic Urticaria in Patients with versus without Subclinical Helicobacter pylori Infection: A Cross-Sectional Study of 150 Patients. Int Arch Allergy Immunol 2018; 175:114-120. [PMID: 29346794 DOI: 10.1159/000485893] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 11/30/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The Helicobacter pylori infection is linked to chronic urticaria in nearly 60% of patients. We studied clinicoepidemiologic features in patients with chronic urticaria with and without H. pylori infection. METHODS Endoscopic antral biopsy for the rapid urease test (RUT) and histopathology, and serum IgG ELISA for H. pylori infection were performed in 150 patients (male:female ratio 1:2.4) of chronic urticaria aged 18-68 years. Clinicoepidemiologic features including age, gender, age of onset and duration, frequency and distribution of wheals, urticaria severity score, and systemic symptoms were analyzed in patients with and without H. pylori. The results of serum IgG ELISA for H. pylori were compared with 106 age- and gender-matched healthy adult controls. RESULTS The RUT in 84 patients (56%), histopathology in 76 patients (50.6%), and H. pylori IgG ELISA in 94 patients (62.6%) were positive. H. pylori IgG ELISA was positive only in 35 (33%) controls, suggesting that chronic urticaria patients were more likely to have asymptomatic H. pylori infection than normal controls. Although not statistically significant, patients with H. pylori had a higher mean urticaria severity score, number of urticaria/angioedema episodes per year, and involvement of more body sites, particularly the scalp, palms, and soles. The constitutional or gastrointestinal symptoms were statistically higher in patients with H. pylori infection than those without it. CONCLUSION A subset of chronic urticaria patients appears to have asymptomatic H. pylori infection. However, its implications in chronicity, recurrences, the severity of urticaria, other systemic manifestations, and management remains conjectural in view of 33% of controls also having positive H. pylori ELISA and the endemicity of infection in developing countries.
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Affiliation(s)
- Sakshi Kohli
- Department of Dermatology, Venereology and Leprosy, Dr. R.P. Govt. Medical College, Kangra, India
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Dolak W, Bilgilier C, Stadlmann A, Leiner J, Püspök A, Plieschnegger W, Siebert F, Wewalka F, Schöfl R, Huber-Schönauer U, Datz C, Biowski-Frotz S, Högenauer C, Schrutka-Kölbl C, Makristathis A, Schöniger-Hekele M, Steininger C. A multicenter prospective study on the diagnostic performance of a new liquid rapid urease test for the diagnosis of Helicobacter pylori infection. Gut Pathog 2017; 9:78. [PMID: 29299067 PMCID: PMC5740919 DOI: 10.1186/s13099-017-0226-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 12/08/2017] [Indexed: 12/22/2022] Open
Abstract
Background Helicobacter pylori (H. pylori) causes a diversity of gastric diseases. Rapid urease tests (RUT) are well established for the point-of-care, invasive diagnosis of H. pylori infection. The study aimed to evaluate the diagnostic performance of a new liquid RUT, the preOx-HUT, within a prospective cohort of treatment-naïve patients. Methods The multicenter prospective clinical trial was conducted at nine Austrian centers for gastrointestinal endoscopy. Patients referred for a diagnostic upper gastrointestinal endoscopy underwent gastric biopsy sampling for routine histological evaluation, and in parallel, the preOx-HUT. Histology served as reference standard to evaluate the diagnostic performance of the preOx-HUT. Results From January 2015 to January 2016, a total of 183 consecutive patients (54 males and 129 females, median age 50 years) were included. Endoscopy revealed pathological findings in 149/183 cases (81%), which were mostly gastritis (59%) and gastro-esophageal reflux disease (27%). H. pylori infection was detected by histology in 41/183 (22%) cases. In relation to histology, the preOx-HUT had a sensitivity of 85%, a specificity of 94%, a positive predictive value of 80% and a negative predictive value of 96%. Performance of preOx-HUT was not affected significantly by concomitant PPI-use as present in 15% of cases (P = 0.73). Conclusions This was the first study evaluating the preOx-HUT in a prospective, multicenter clinical setting. We found a high diagnostic accuracy for the point-of-care, invasive diagnostic test of H. pylori infection. Hence, this test may be a valuable diagnostic adjunct to the clinical presentation of patients with suspected H. pylori infection. Trial registration number EK 1548/2014, Name of registry: Register der Ethikkommission der Medizinischen Universität Wien, URL of registry: https://ekmeduniwien.at/core/catalog/2012/, Date of registration: 24.09.2014, Date of enrolment of the first participant to the trial: 15.01.2015 Electronic supplementary material The online version of this article (10.1186/s13099-017-0226-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Werner Dolak
- Gastroenterology and Hepatology, Internal Medicine III., Medical University of Vienna, Vienna, Austria
| | - Ceren Bilgilier
- Department of Medicine I, Infectious Diseases, Internal Medicine I, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Alexander Stadlmann
- Department of Medicine I, Infectious Diseases, Internal Medicine I, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Judith Leiner
- Internal Medicine, Ladislaus Batthyány-Strattmann Hospital Kittsee, Kittsee, Austria
| | - Andreas Püspök
- Internal Medicine II, Hospital of the Brothers of Saint John of God Eisenstadt, Eisenstadt, Austria
| | - Wolfgang Plieschnegger
- Internal Medicine, Hospital of the Brothers of Saint John of God St Veit/Glan, St Veit, Austria
| | - Franz Siebert
- Internal Medicine, Hospital of the Brothers of Saint John of God St Veit/Glan, St Veit, Austria
| | | | - Rainer Schöfl
- Internal Medicine 4, Elisabethinen Hospital Linz, Linz, Austria
| | | | - Christian Datz
- Internal Medicine, Hospital Oberndorf, Oberndorf, Austria
| | | | - Christoph Högenauer
- Gastroenterology and Hepatology, Internal Medicine, Medical University of Graz, Graz, Austria
| | | | | | | | - Christoph Steininger
- Department of Medicine I, Infectious Diseases, Internal Medicine I, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
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Abstract
OBJECTIVE This study aimed to evaluate the optimal biopsy site for Helicobacter pylori detection by comparing the results of rapid urease test (RUT) between the gastric corpus and the antrum. METHODS A biopsy specimen from each subject was obtained from the corpus and from the antrum. For each subject, the two specimens were separately immersed in two different RUT kits. Positive reaction times were measured at 20 minutes and 1, 3, and 24 hours. If either of the two RUT kits showed a positive reaction, H. pylori infection was confirmed. RESULTS A total of 310 H. pylori-infected subjects were eligible for study inclusion. Compared with the antrum, positive RUT reaction times in the corpus were shorter when the degree of gastric atrophy was moderate or severe (p = .001 and p < .001, respectively). A multivariate analysis revealed that the factors resulting in a faster positive RUT reaction in the corpus were age ≥50 years (odds ratio [OR] = 1.84; 95% confidence interval [CI] = 1.10-3.08; p = .021) and severe gastric atrophy (OR = 2.41; 95% CI = 1.13-5.13; p = .023). Also, severe gastric atrophy was an independent factor associated with positive RUT reaction only in the corpus (OR = 5.12; 95% CI = 1.55-16.88; p = .007). CONCLUSIONS In subjects aged ≥50 years or with severe gastric atrophy, biopsy of the corpus mucosa optimized the efficiency of H. pylori detection through a faster positive RUT reaction.
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Affiliation(s)
- Jun-Hyung Cho
- a Digestive Disease Center , Soonchunhyang University Hospital , Seoul , Korea
| | - Seong Ran Jeon
- a Digestive Disease Center , Soonchunhyang University Hospital , Seoul , Korea
| | - Hyun Gun Kim
- a Digestive Disease Center , Soonchunhyang University Hospital , Seoul , Korea
| | - So-Young Jin
- b Department of Pathology , Soonchunhyang University Hospital , Seoul , Korea
| | - Suyeon Park
- c Department of Medical Biostatistics , Soonchunhyang University Hospital , Seoul , Korea
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Luo XF, Jiao JH, Zhang WY, Pu HM, Qu BJ, Yang BY, Hou M, Ji MJ. Establishment of a nested-ASP-PCR method to determine the clarithromycin resistance of Helicobacter pylori. World J Gastroenterol 2016; 22:5822-5830. [PMID: 27433095 PMCID: PMC4932217 DOI: 10.3748/wjg.v22.i25.5822] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 04/08/2016] [Accepted: 04/20/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate clarithromycin resistance positions 2142, 2143 and 2144 of the 23SrRNA gene in Helicobacter pylori (H. pylori) by nested-allele specific primer-polymerase chain reaction (nested-ASP-PCR).
METHODS: The gastric tissue and saliva samples from 99 patients with positive results of the rapid urease test (RUT) were collected. The nested-ASP-PCR method was carried out with the external primers and inner allele-specific primers corresponding to the reference strain and clinical strains. Thirty gastric tissue and saliva samples were tested to determine the sensitivity of nested-ASP-PCR and ASP-PCR methods. Then, clarithromycin resistance was detected for 99 clinical samples by using different methods, including nested-ASP-PCR, bacterial culture and disk diffusion.
RESULTS: The nested-ASP-PCR method was successfully established to test the resistance mutation points 2142, 2143 and 2144 of the 23SrRNA gene of H. pylori. Among 30 samples of gastric tissue and saliva, the H. pylori detection rate of nested-ASP-PCR was 90% and 83.33%, while the detection rate of ASP-PCR was just 63% and 56.67%. Especially in the saliva samples, nested-ASP-PCR showed much higher sensitivity in H. pylori detection and resistance mutation rates than ASP-PCR. In the 99 RUT-positive gastric tissue and saliva samples, the H. pylori-positive detection rate by nested-ASP-PCR was 87 (87.88%) and 67 (67.68%), in which there were 30 wild-type and 57 mutated strains in gastric tissue and 22 wild-type and 45 mutated strains in saliva. Genotype analysis showed that three-points mixed mutations were quite common, but different resistant strains were present in gastric mucosa and saliva. Compared to the high sensitivity shown by nested-ASP-PCR, the positive detection of bacterial culture with gastric tissue samples was 50 cases, in which only 26 drug-resistant strains were found through analyzing minimum inhibitory zone of clarithromycin.
CONCLUSION: The nested-ASP-PCR assay showed higher detection sensitivity than ASP-PCR and drug sensitivity testing, which could be performed to evaluate clarithromycin resistance of H. pylori.
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Calik Z, Karamese M, Acar O, Aksak Karamese S, Dicle Y, Albayrak F, Can S, Guvendi B, Turgut A, Cicek M, Yazgi H. Investigation of Helicobacter pylori antigen in stool samples of patients with upper gastrointestinal complaints. Braz J Microbiol 2016; 47:167-71. [PMID: 26887240 PMCID: PMC4822757 DOI: 10.1016/j.bjm.2015.11.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 08/23/2015] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori infection is usually acquired in early childhood and it can persist throughout life without antibiotic treatment. This study aimed to compare the accuracy of the noninvasive H. pylori Stool Antigen Test-applied on the stool samples with the invasive gold standart Rapid Urease Test-applied on the gastric biopy samples of patients with upper gastrointestinal complaints. After endoscopy, biopsy and stool specimens were taken in 122 patients. The infection was detected with rapid urease test which is accepted as gold standart test. Rapid, one-step H. pylori card test was applied to all patients stool specimens. In this study 106 of the 122 patients (86.8%) were positive for H. pylori infection, while 16 of the 122 patients (13.2%) were negative. H. pylori card test was negative in 13 of the 16 patients and was positive in 98 of the 106. The sensitivity, specifity, positive and negative predictive values were 92.45%, 81.25%, 97.02%, and 61.90%, respectively. H. pylori card test is rapid, easy, noninvasive and inexpensive methods for detection H. pylori infection. This test showed high sensitivity and specificity. Additionally, it may be a good alternative to invasive tests for the detection of H. pylori infections especially in children.
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Affiliation(s)
- Zeki Calik
- Department of Microbiology, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Murat Karamese
- Department of Microbiology, Faculty of Medicine, Kafkas University, Kars, Turkey.
| | - Osman Acar
- Department of Microbiology, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Selina Aksak Karamese
- Department of Histology and Embryology, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Yalcin Dicle
- Department of Nursing, School of Health, Mus Alparslan University, Mus, Turkey
| | - Fatih Albayrak
- Department of Internal Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Serpil Can
- Department of Physiology, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Bulent Guvendi
- Department of Genereal Surgery, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Alpgiray Turgut
- Department of Biochemistry, Faculty of Veterinary, Ataturk University, Erzurum, Turkey
| | - Mustafa Cicek
- Department of Anatomy, Faculty of Medicine, Gazi Osman Pasa University, Tokat, Turkey
| | - Halil Yazgi
- Department of Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
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Abstract
Accurate diagnosis of Helicobacter pylori infection pre- and post-treatment is mandatory in the current era of decreasing prevalence and increasing antibiotic resistance. The diagnostic performance of most tests is poorer in clinical situations with low bacterial density which is seen in conditions such as atrophic gastritis or intake of antisecretory and antibiotic medications. Noninvasive tests require less cost and resource but provide excellent accuracy; however, endoscopy with testing of gastric biopsy specimens is indicated where alarming symptoms are present or antibiotic susceptibility testing by culture is desired. Newer modalities such as polymerase chain reaction testing provide additional virulence and antibiotic sensitivity profiling. This article outlines new developments and the key parameters of each test, as careful selection of test modality within the clinical context is required for adequate management of infected symptomatic patients.
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Affiliation(s)
- Nathan S S Atkinson
- Translational Gastroenterology Unit, Oxford University Hospitals NHS Trust, Headley Way, Oxford, OX3 9DU, UK
| | - Barbara Braden
- Translational Gastroenterology Unit, Oxford University Hospitals NHS Trust, Headley Way, Oxford, OX3 9DU, UK.
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Haji-Aghamohammadi AA, Bastani A, Miroliaee A, Oveisi S, Safarnezhad S. Comparison of levofloxacin versus clarithromycin efficacy in the eradication of Helicobacter pylori infection. Caspian J Intern Med 2016; 7:267-271. [PMID: 27999644 PMCID: PMC5153518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Helicobacter pylori (H.pylori) infection causes multiple upper gastrointestinal diseases but optimal therapeutic regimen which can eradicate infection in all the cases has not yet been defined. This study was designed to evaluate the efficacy of triple levofloxacin-based versus clarithromycin-based therapy. METHODS In this open-label randomized clinical trial study 120 patients who had esophagogastroduodenoscopy (EGD) with positive rapid urease test (RUT) were enrolled and divided into 2 groups. Case group was treated with levofloxacin (500 mg daily) plus amoxicillin (1 gr twice a day) plus omeprazole (20 mg daily) for 2 weeks. Control group was treated with clarithromycin (500 mg twice a day) plus omeprazole (20 mg daily) for 2 weeks. After the main course of treatment, they received maintenance treatment with omeprazole for 4 weeks. Stool antigen test was performed on them after two weeks of not having any medicine. RESULTS H.pylori eradication (intention to treat analysis) was successful in 75% of case group and 51.7% of control group showing a significant difference (P=0.008). H.p infection eradication (per-protocol analysis) was successful in 80.4% in case group and 57.4%% in control group showing significant difference (P=0.009). Drugs adverse effects causing discontinuation treatment were seen in 5% of case group and 3.3% of control group which have not shown a significant difference between the two groups (P=0.648). CONCLUSION Triple therapy with levofloxacin-based regimen has better efficacy than clarithromycin-based regimen and as safe as it is.
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Affiliation(s)
- Ali Akbar Haji-Aghamohammadi
- Department of Internal Medicine,Velayat Clinical Research Development Unit, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Ali Bastani
- Department of Internal Medicine,Velayat Clinical Research Development Unit, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Arash Miroliaee
- Department of Internal Medicine,Velayat Clinical Research Development Unit, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sonia Oveisi
- Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Saeed Safarnezhad
- Department of Internal Medicine,Velayat Clinical Research Development Unit, Qazvin University of Medical Sciences, Qazvin, Iran.,Correspondence: Saeed Safarnezhad, Velayat Clinical Research Development Unit, Velayat Hospital, 22 Bahman Blvd, Qazvin, Iran, P.O.BOX 34719-76161, E-mail: , Tel: 0098 2833760620, Fax: 0098 2833790611
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Goji S, Tamura Y, Sasaki M, Nakamura M, Matsui H, Murayama SY, Ebi M, Ogasawara N, Funaki Y, Kasugai K. Helicobacter suis-Infected Nodular Gastritis and a Review of Diagnostic Sensitivity for Helicobacter heilmannii-Like Organisms. Case Rep Gastroenterol 2015; 9:179-87. [PMID: 26120299 PMCID: PMC4478311 DOI: 10.1159/000431169] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Helicobacter heilmannii-like organisms (HHLOs) are associated with mucosa-associated lymphoid tissue lymphoma and peptic ulcer. However, the sensitivity of diagnostic tests for HHLOs, such as rapid urease test (RUT), urea breath test (UBT) and blood antibody, is not high. Tightly coiled spiral microorganisms were found in the gastric mucosal biopsy specimen of a 48-year-old asymptomatic woman. Her findings were positive for RUT and UBT, but negative for blood antibody and stool antigen against H. pylori. A 7-day course of esomeprazole, amoxicillin and clarithromycin was administered, resulting in the successful eradication of the HHLOs. Analysis of the 16S rRNA and urease genes suggested a diagnosis of the HHLO H. suis. The sensitivity results of RUT, UBT, culture, blood antibody, immunohistochemistry and stool antigen were 40.0, 14.8, 0, 23.1, 40.0 and 0%, respectively. We report asymptomatic nodular gastritis due to an HHLO. Histological techniques, most likely with smears, are expected to be the most effective method for diagnosing infections by HHLOs, and genetic diagnosis by polymerase chain reaction can be very useful to identify the species of HHLOs.
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Affiliation(s)
- Shigeki Goji
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | | | - Hidenori Matsui
- Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
| | - Somay Yamagata Murayama
- Laboratory of Molecular Cell Biology, School of Pharmacy, Nihon University, Funabashi, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
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Ochung'o OP, Mugwe P, Masinde P, Waweru W. Prevalence of H. Pylori in Tonsillar Tissue of Patients with Chronic Recurrent Tonsillitis Using Rapid Urease Test in a Tertiary Referral Hospital in Sub Saharan Africa. Indian J Otolaryngol Head Neck Surg 2014; 67:223-6. [PMID: 26405654 DOI: 10.1007/s12070-014-0754-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Accepted: 07/23/2014] [Indexed: 01/18/2023] Open
Abstract
There has been conflicting results regarding the presence of H. pylori in tonsillar tissue. Our objective was to analyze for the presence of H. pylori in tonsillar tissue in patients undergoing tonsillectomy for chronic recurrent tonsillitis using rapid urease test in a Tertiary care academic medical center in a sub Saharan hospital. A prospective cross-sectional analysis of 39 consecutive cases of patients undergoing tonsillectomy secondary to chronic recurrent tonsilitis was done. Rapid urease test was conducted on each tonsillectomy tissue and results were determined using color change at specific time intervals within 24 h. Average age of the patients was 4.3 years. Among the 39 tonsillar tissues analysed using rapid urease test, H. pylori was present in 30.5 % of the samples. Colonisation by H. pylori of the palatine tonsils is a new frontier with conflicting results depending on the accuracy of the test method used and population studied. More studies need to be performed to ascertain the different rates of colonisation based on geographical regions.
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Affiliation(s)
- O Peter Ochung'o
- Department of Ear, Nose and Throat Head and Neck Surgery, University of Nairobi, Uhuru Highway, Nairobi, 00100 Kenya ; Department of Otolaryngology-Head and Neck Surgery, University of Nairobi, P.O. Box 580-00600, Nairobi, Kenya
| | - P Mugwe
- Department of Ear, Nose and Throat Head and Neck Surgery, University of Nairobi, Uhuru Highway, Nairobi, 00100 Kenya
| | - P Masinde
- Department of Ear, Nose and Throat Head and Neck Surgery, University of Nairobi, Uhuru Highway, Nairobi, 00100 Kenya
| | - W Waweru
- Department of Pathology, University of Nairobi, Uhuru Highway, Nairobi, 00100 Kenya
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Quach DT, Hiyama T, Shimamoto F, Le QD, Ho LX, Vu NHT, Yoshihara M, Uemura N. Value of a new stick-type rapid urine test for the diagnosis of Helicobacter pylori infection in the Vietnamese population. World J Gastroenterol 2014; 20:5087-5091. [PMID: 24803823 PMCID: PMC4009545 DOI: 10.3748/wjg.v20.i17.5087] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 02/10/2014] [Accepted: 03/05/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the value of a new test for the diagnosis of Helicobacter pylori (H. pylori) infection, Rapirun®H. pylori Antibody Stick (Rapirun® Stick), in a Vietnamese population.
METHODS: Eligible patients without previous history of H. pylori eradication were recruited. Rapid urease test (RUT) and histologic examination were used to diagnose the H. pylori infection. Patients were considered H. pylori positive when the RUT results were positive and/or the bacteria were detected histologically. Rapirun® Stick tests were performed using urine samples, and the results were compared with the other 2 methods.
RESULTS: We enrolled 200 patients with a mean age of 36 (range, 18-76) years. There were 116 females and 84 males. Of the 200 patients, 111 (55.5%) were diagnosed as being H. pylori positive. The sensitivity, specificity, and accuracy of the Stick test were 84.7%, 89.9%, and 87.0%, respectively. There were 17 (8.5%) false-negative patients and 9 (4.5%) false-positive patients.
CONCLUSION: The Rapirun® Stick test has high sensitivity, specificity, and accuracy for the diagnosis of H. pylori infection in the Vietnamese population. The test can be clinically applied in Vietnamese populations.
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Adlekha S, Chadha T, Krishnan P, Sumangala B. Prevalence of helicobacter pylori infection among patients undergoing upper gastrointestinal endoscopy in a medical college hospital in kerala, India. Ann Med Health Sci Res 2013; 3:559-63. [PMID: 24380008 PMCID: PMC3868123 DOI: 10.4103/2141-9248.122109] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Helicobacter pylori related gastritis is a major health ailment in developing nations. There is high morbidity and mortality ranging from chronic gastritis to gastric malignancies. Prevalence of H. pylori infection varies markedly from country to country and in a country, region to region. AIM To study the prevalence of H. pylori gastritis in patients undergoing endoscopy and its association with the development of gastrointestinal diseases. SUBJECTS AND METHODS The study was carried out in a Medical College Hospital in Kerala, India. Patients presenting with dyspeptic symptoms were subjected to upper gastrointestinal endoscopy and investigated for H. pylori infection through histopathological examination and rapid urease test of biopsy specimen. Diagnosis of H. pylori infection was made if one or both diagnostic test results were positive. Data analysis was carried out using the statistical package for social sciences, for Windows version 16.0 (SPSS 16; Chicago, IL, USA). RESULTS H. pylori infection was diagnosed in 62.0% (329/530) of patients screened. There was no statistically significant difference in sex and age related distribution (<50 year age group and >50 year age group) of H. pylori infection. However, a statistically significant association of H. pylori infection with the presence of endoscopic abnormalities, peptic ulcer, and dysplasia/cancer was seen. CONCLUSION The prevalence of H. pylori infection is significantly high in rural and suburban population of Ernakulam district, Kerala. Early detection and prompt treatment are essential for prevention of serious complications.
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Affiliation(s)
- S Adlekha
- Department of Pathology, Sree Narayana Institute of Medical Sciences, Chalakka, Ernakulam, Kerala, India
| | - T Chadha
- Department of Microbiology, Sree Narayana Institute of Medical Sciences, Chalakka, Ernakulam, Kerala, India
| | - P Krishnan
- Department of Surgery, Sree Narayana Institute of Medical Sciences, Chalakka, Ernakulam, Kerala, India
| | - B Sumangala
- Department of Pathology, Sree Narayana Institute of Medical Sciences, Chalakka, Ernakulam, Kerala, India
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29
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Moon SW, Moon SW, Kim TH, Kim HS, Ju JH, Ahn YJ, Jang HJ, Shim SG, Kim HJ, Jung WT, Lee OJ. United Rapid Urease Test Is Superior than Separate Test in Detecting Helicobacter pylori at the Gastric Antrum and Body Specimens. Clin Endosc 2012; 45:392-6. [PMID: 23251887 PMCID: PMC3521941 DOI: 10.5946/ce.2012.45.4.392] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 06/15/2012] [Accepted: 06/16/2012] [Indexed: 12/16/2022] Open
Abstract
Background/Aims The rapid urease test (RUT) is an invasive method to diagnose Helicobacter pylori infection, which relies on the acquisition and examination of gastric antrum and body tissues. We determined and compared the efficacy of RUT when the tissues were examined separately or after being combined. Methods Two hundred and fourteen patients were included and underwent esophagogastroduodenoscopy from July 2008 to June 2010. The separate test was defined as evaluating the status of infectivity of H. pylori from the antrum and body separately; whereas the united test was carried out putting both tissues from the antrum and body in the same RUT kit. All RUTs were read by a single observer 1, 3, 6, 12, and up to 24 hours later. We also got two biopsy specimens stained with hematoxylin and eosin and quantified H. pylori density was calculated on a scale of 0 to 3. Results Overall positivity for H. pylori was 137 (64%) for the separate test and 148 (69.2%) for the united test (p<0.01). The mean time to a positive test was 3.58 hours for the separate test and 1.69 hours for the united test (p<0.01). The correlation between the time to positive RUT and the severity of histology showed r=+0.556 for the antrum (p<0.01) and r=+0.622 for the body (p<0.01). Conclusions Combining tissues prior to RUT enhances the detection of H. pylori, as compared with the examination of separate tissues, and shortens the time to develop a positive reaction by approximately 50%. These diagnostic advantages are also accompanied by increased cost-savings.
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Affiliation(s)
- Sung Won Moon
- Department of Internal Medicine and Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea
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Farivar TN, Pahlevan A, Johari P, Safdarian F, Mehr MA, Najafipour R, Ahmadpour F. Assessment of helicobacter pylori prevalence by scorpion real-time PCR in chronic tonsillitis patients. J Glob Infect Dis 2012; 4:38-42. [PMID: 22529626 PMCID: PMC3326956 DOI: 10.4103/0974-777x.93760] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: Occasionally, bacteria or viruses enter the tonsils and these organs become overwhelmed by bacterial or viral infection leading to inflammation. Some studies confirmed the presence of Helicobacter pylori in tonsillar specimens of patients suffering from chronic tonsillitis and some others did not. The difference in results in various studies might be due to different laboratory methods. The aim of this study was to investigate the presence of H. pylori Deoxynucleic acid (DNA) in archival tonsillar tissues of patients with chronic tonsillitis by a rapid, sensitive, and specific technique of Scorpion real-time polymerase chain reaction (PCR). Materials and Methods: Scorpion real-time PCR and modified McMullen's staining was performed on 103 archival paraffin-embedded tonsillar samples collected from patients with chronic tonsillitis following tonsillectomy operation. Results: Our findings showed that H Cell and Molecular Research Center. pylori DNA was present in 21.35% of total specimens by using Scorpion real-time PCR. Modified McMullen's staining of paraffin-embedded sections was positive in 19 patients. Out of our 103 samples, 50 samples showed positive a rapid urease test whereas 53 samples demonstrated negative results, 20 produced positive PCR results, and 83 were negative for H. pylori. There was no significant relationship between the presence of H. pylori, sex, age, and place of residence. Conclusion: Although the existence of H. pylori in tonsillar tissue samples of patients with chronic tonsillitis is controversial, however, our results showed that in our studied specimens, a significant number of patients with chronic tonsillitis had H. pylori colonization.
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Affiliation(s)
- T Naserpour Farivar
- Cell and Molecular Research Center, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
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Shahidi MA, Fattahi MR, Farshad S, Alborzi A. Validation of an in-house made rapid urease test kit against the commercial CLO-test in detecting Helicobacter pylori infection in the patients with gastric disorders. J Res Med Sci 2012; 17:212-6. [PMID: 23267370 PMCID: PMC3527036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Revised: 12/03/2011] [Accepted: 01/10/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND H. pylori is a urease positive organism, and this activity in a gastric biopsy could be considered as a proof of the presence of H. pylori. For the reasons of high price and difficult accessibility to the commercial CLO-test in Iran, we designed an affordable equivalent test with high specificity, accuracy and availability. METHODS Biopsy samples from 80 symptomatic patients with gastrointestinal problems were included in this study. The results of our in-house made rapid urease kit were compared with the commercial CLO-test up to 3 hours and 24 hours after inoculation of the biopsy samples. Culture results and gram staining were proposed as gold standard. RESULTS Helicobacter pylori was isolated from 36 patients (45.0%) after cultivation of biopsy samples. After 3 hours, 33 (91.6%) cases of positive samples for H. pylori, showed urease positive reaction using both, in-house made and CLO-test kits. However, 2 (5.5%) cases showed urease reaction at 24 hours using both the kits. The specificity of 100% was determined for both, in-house made and commercial CLO-test kits after 3 hours. The sensitivity for both the kits was estimated at 97.1% after 3hours. However, after 24 hours, sensitivity and specificity of 97.1% and 88.64% was estimated for the in-house and 97.2 % and 95.4% for the commercial CLO-test kits, respectively. CONCLUSION Specificity and sensitivity of 100% and 97.1 % for up to 3 hours follow biopsy sampling, could be considered as an advantage for our in-house rapid urease kit. Moreover, the rapid urease agar media designed in our lab is cost-effective with adequate sensitivity and specificity levels for the detection of H. pylori, compared with the commercial CLO-test.
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Affiliation(s)
- Maneli Amin Shahidi
- Department of Bacteriology, Prof. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Fattahi
- Associate Professor, Gastroenterohepathology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shohreh Farshad
- Associate Professor, Prof. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Address for correspondence: Mrs. Shohreh Farshad, Associate professor, Prof. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Nemazee Hospital, Shiraz 71937-11351, Iran. E-mail:
| | - Abdolvahab Alborzi
- Professor, Prof. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Seth AK, Kakkar S, Manchanda GS. Role of Biopsy from Gastric Corpus in Diagnosis of Helicobacter pylori Infection in Patients on Acid Suppression Therapy. Med J Armed Forces India 2011; 59:216-7. [PMID: 27407519 DOI: 10.1016/s0377-1237(03)80010-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There are reports of migration of Helicobacter pylori from the gastric antrum to the proximal stomach following acid suppression therapy. The diagnosis of H pylori infection is usually based on rapid urease test and histology of gastric antral biopsies. 50 consecutive patients of peptic ulcer, 22 on proton pump inhibitors and 28 on histamine-2 receptor antagonists for at least 4 weeks were subjected to biopsies from the gastric corpus in addition to the antrum at the time of upper gastrointestinal endoscopy. H pylori infection was detected in 42 (84%) patients. The diagnosis was established from both antral and corpus biopsies in 34 (68%) and only antrum in 4 (8%). In 4 patients, 3 on proton pump inhibitors and one on H-2 receptor antagonists, H pylori was isolated only from the corpus. The rapid urease test was positive at a mean time of 67.6 minutes from the antrum as compared to 234.6 minutes from the corpus. Testing for H pylori from the antrum alone and not the corpus would have resulted in a false negative result in 8% patients. Biopsy from the gastric antrum should always be combined with biopsy from gastric corpus for the diagnosis of H pylori infection in patients with dyspepsia on acid suppression therapy.
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Affiliation(s)
- A K Seth
- Classified Specialist, (Medicine and Gastroenterology), Army Hospital (R&R), Delhi Cantt - 110 010
| | - S Kakkar
- Classified Specialist (Pathology), Command Hospital (Eastern Command), Kolkata - 700 027
| | - G S Manchanda
- Senior Advisor (Pathology), Command Hospital (Eastern Command), Kolkata - 700 027
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Abstract
INTRODUCTION Determination of the true prevalence of Helicobacter pylori (H. pylori) is difficult in a hyper-endemic area like Nigeria with use of serological tests because of their low discriminatory power between previous and current infections. The use of biopsy based methods will go a long way to mitigate this problem. We investigated the prevalence of H. pylori in dyspeptic patients and its relationship with gastroduodenal pathologies using gastric biopsy histology and rapid urease test. METHODS Eighty-six consecutive adult patients with dyspepsia underwent upper gastrointestinal endoscopy using forward-viewing endoscopes. Antral biopsy specimens were collected for histology and rapid urease test. Diagnosis of H. pylori infection was made if both or either of the tests was positive. RESULTS Of the 86 subjects, there were 39 (45.3%) males and 47 (54.7%) females. The age range was 23 to 85 years with a mean of 49.19±13.75 years. Diagnosis of H. pylori was made in 55 (64%) patients. Gastritis was the commonest endoscopic finding (60.5%), serious gastroduodenal pathology (gastric ulcer, duodenal ulcer and gastric cancer) were documented in only 12 (14%) patients. Thirty three (63.5%) of the 55 patients with gastritis had H. pylori infection while 7 (58.3%) of the 12 patients with serious gastroduodenal lesions had the infection. Thirteen (72.2%) of the 18 patients that had normal endoscopic findings were H. pylori positive. CONCLUSION The prevalence of H. pylori among dyspeptics using biopsy based methods is high in the South-Western part of Nigeria. It is therefore important to test and treat H. pylori among Nigerians with dyspepsia.
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Hsu WH, Wang SSW, Kuo CH, Chen CY, Chang CW, Hu HM, Wang JY, Yang YC, Lin YC, Wang WM, Wu DC, Wu MT, Kuo FC. Dual specimens increase the diagnostic accuracy and reduce the reaction duration of rapid urease test. World J Gastroenterol 2010; 16:2926-30. [PMID: 20556840 PMCID: PMC2887590 DOI: 10.3748/wjg.v16.i23.2926] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the influence of multiple samplings during esophagogastroduodenoscopy (EGD) on the accuracy of the rapid urease test, and the validity of newly developed rapid urease tests, HelicotecUT plus test and HelicotecUT test, CLO test and ProntoDry test.
METHODS: A total of 355 patients undergoing EGD for dyspepsia were included. Their Helicobacter pylori (H. pylori) treatment status was either naïve or eradicated. Six biopsy specimens from antrum and gastric body, respectively, were obtained during EGD. Single antral specimens and dual (antrum + body) specimens were compared. Infection status of H. pylori was evaluated by three different tests: culture, histology, and four different commercially available rapid urease tests (RUTs)-including the newly developed HelicotecUT plus test and HelicotecUT test, and established CLO test and ProntoDry test. H. pylori status was defined as positive when the culture was positive or if there were concordant positive results among histology, CLO test and ProntoDry test.
RESULTS: When dual specimens were applied, sensitivity was enhanced and RUT reaction time was significantly reduced, regardless of their treatment status. Thirty minutes were enough to achieve an agreeable positive rate in all the RUTs. Both newly developed RUTs showed comparable sensitivity, specificity and accuracy to the established RUTs, regardless of patient treatment status, RUT reaction duration, and EGD biopsy sites.
CONCLUSION: Combination of antrum and body biopsy specimens greatly enhances the sensitivity of rapid urease test and reduces the reaction duration to 30 min.
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Syam AF, Abdullah M, Rani AA, Nurdjanah S, Adi P, Djumhana A, Tarigan P, Wibawa IDN. Evaluation of the use of rapid urease test: Pronto Dry to detect H pylori in patients with dyspepsia in several cities in Indonesia. World J Gastroenterol 2006; 12:6216-8. [PMID: 17036399 PMCID: PMC4088121 DOI: 10.3748/wjg.v12.i38.6216] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate Pronto Dry examination in patients with dyspepsia.
METHODS: The study was conducted in patients with dyspepsia who underwent endoscopic examination in several endoscopic centers of several cities in Indonesia from January 2003 until April 2004. Biopsies for histopathologic examination were fixed with formalin and sent to Histopathologic Department to be analyzed and confirm the presence of H pylori infection. If H pylori was found positive, the density was calculated semi quantitatively. Histopathologic examination from gastric biopsy samples was interpreted based on the updated Sydney system classification.
RESULTS: Of 550 patients, 309 (56%) were male and 241 (44%) were female with ages ranging from 15 to 82 years. Mean age was 44.98 ± 14.46 years. Mean age of male patients was 44.35 ± 13.85 years and mean age of female patients was 45.78 ± 15.19 years. Evaluation of endoscopic results showed gastric ulcer in 36 cases (6.5%) and duodenal ulcer in 20 cases (3.6%). Normal endoscopic finding was found in 45 cases (8.2%) and minimal disorder of gastritis and duodenitis were found in 246 cases (44.7%). One case of gastric cancer was identified. Of 56 cases which were positive based on the criteria used, 39 patients were positive with Pronto Dry and 17 patients were negative with Pronto Dry. Overall sensitivity and specificity of Pronto Dry were 69.7% and 95.7% respectively. Positive predictive value was 66.1% and negative predictive value was 96.4% and overall accurate rate was 92.9%.
CONCLUSION: Pronto Dry seems promising as a diagnostic tool to detect H pylori more rapidly and accurately.
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Affiliation(s)
- A-F Syam
- Division of Gastroenterology, Department of Internal Medicine, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia.
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