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Stool Antigen Tests for Helicobacterpylori Infection TITLE: Stool Antigen Tests for Helicobacterpylori Infection: A Review of Clinical and Cost-Effectiveness and Guidelines DATE: 08 January 2015 CONTEXT AND POLICY ISSUES Helicobacterpylori (H. pylori) is Gram negative bacillus that colonizes the mucus layer of the human stomach and the upper part of small intestine (duodenum). 1,2 It is the principal cause of peptic ulcer disease and the main risk of gastric cancer. 2 Most infected (...) the full-text publications for the final article selection, according to selection criteria presented in Table 1. Table 1: Selection Criteria Population Adult patients with suspected Helicobacterpylori infection Intervention Stool antigen tests (other names may be fecal testing for H. pylori, fecal testing, fecal calprotectin assay) Comparator Endoscopy/biopsy procedure Carbon-13 urea breath test Outcomes • Clinical effectiveness and diagnostic accuracy (accuracy, clinical benefit, patient harms
Diagnosis of Helicobacterpylori Using Invasive and Noninvasive Approaches Helicobacterpylori (H. pylori) as gram-negative and spiral microorganism is responsible for colonization in the gastric microniche for more than 50% of world population. Recent studies have shown a critical role of H. pylori in the development of peptic ulcers, gastric mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric cancer. Over the past decade, there has been a sharp interest to use noninvasivetests (...) in diagnosis of the H. pylori infection. During the years after discovery by Marshall and Warren, it has been frequently declared that the rapid urease test (RUT) is one of the cheapest and rapid diagnostic approaches used in detecting the infection. Although the specificity and sensitivity are durable for this test, clinical experiences had shown that the ideal results are only achieved only if we take biopsies from both corpus and antrum at the same time. Given the diagnosis of the H. pylori in clinical
, Terzi Y. Comparison of the diagnostic values of the 3 different stool antigen tests for the noninvasive diagnosis of Helicobacterpylori infection. J Investig Med. 2010 Dec;58(8):982-6. PubMed: PM20729762 16. Mahmood S, Hamid A. Comparison between invasive and noninvasivetests in diagnosis of Helicobacterpylori infection. Pak J Biol Sci. 2010 May 15;13(10):509-12. Non-Invasive Testing for Patients with Suspected H. pylori 7 PubMed: PM21848076 17. Palka M, Tomasik T, Windak A, Margas G, Mach T (...) of Helicobacterpylori infection in children. World J Gastroenterol [Internet]. 2009 Jan 28 [cited 2012 Sep 10];15(4):484-8. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2653372 PubMed: PM19152455 25. Peng NJ, Lai KH, Lo GH, Hsu PI. Comparison of noninvasive diagnostic tests for Helicobacterpylori infection. Med Princ Pract. 2009;18(1):57-61. PubMed: PM19060493 Non-Invasive Testing for Patients with Suspected H. pylori 8 26. Shimoyama T, Oyama T, Matsuzaka M, Danjo K, Nakaji S, Fukuda S
Noninvasive molecular analysis of Helicobacterpylori: Is it time for tailored first-line therapy? The main problem of Helicobacterpylori (H. pylori) infection management is linked to antibiotic resistances. This phenomenon has grown in the last decade, inducing a dramatic decline in conventional regimen effectiveness. The causes of resistance are point mutations in bacterial DNA, which interfere with antibiotic mechanism of action, especially clarithromycin and levofloxacin. Therefore (...) of a potential availability of noninvasive investigations able to detect H. pylori resistances to antibiotics. These kinds of analysis are currently at a very early phase of development and caution should be paid about their clinical application. Only further studies aimed to evaluate their sensitivity and specificity will afford novel data for solid considerations. Nevertheless, noninvasive molecular tests may improve patient compliance, time/cost of infection management and therapeutic outcome. Moreover
for 14 days or bismuth- based quadruple therapy is recommended. Success of therapy should be monitored after 4 to 8 weeks by reliable noninvasivetests. Conclusions: The primary goal of clinical investigation is to identify the cause of upper gastrointestinal symptoms rather than H pylori infection. Therefore, we recommend against a test and treat strategy. Decreasing eradication rates with previously recommended treatments call for changes to ?rst-line therapies and broader availability of culture (...) or molecular-based testing to tailor treatment to the individual child. Key Words: adolescents, antibiotic susceptibility, 13 C-urea breath test, children, eradication, Helicobacterpylori, triple therapy (JPGN 2017;64: 991–1003) H elicobacter pylori infection is acquired in childhood and remains an important cause of peptic ulcer disease (PUD) and gastric cancer (1). In comparison with adults, children and adolescents, however, infrequently develop these complications of infection. FurthermoreHpylori
pylori infection-comparison between infrared spectrometer and mass spectrometry analysis. Alimentary pharmacology & therapeutics. 2000;14(10):1359-63. 43. Chen TS, Chang FY, Chen PC, Huang TW, Ou JT, Tsai MH, et al. Simplified 13C-urea breath test with a new infrared spectrometer for diagnosis of Helicobacterpylori infection. Journal of gastroenterology and hepatology. 2003;18(11):1237-43. 44. Peng N-J, Lai K-H, Lo G-H, Hsu P-I. Comparison of noninvasive diagnostic tests for Helicobacterpylori (...) Point-of-care testing for Heliobacter pylori infection NIHR Diagnostic Evidence Cooperative Oxford www.oxford.dec.nihr.ac.uk Diagnostic Evidence Co-operative Oxford Clinical Question: In adults attending primary care with upper gastrointestinal symptoms, what is the accuracy and utility of point-of-care testing to detect Helicobacterpylori infection? Background Helicobacterpylori (HP) is a spiral-shaped gram-negative bacterium with unipolar sheathed flagellae often tipped with a distinctive
Impact of patient adherence on the cost-effectiveness of noninvasivetests for the initial diagnosis of Helicobacterpylori infection in the United States Previous US-based economic models of noninvasivetests for diagnosis of Helicobacterpylori infection did not consider patient adherence or downstream costs of continuing infection. This analysis evaluated the long-term cost-effectiveness of the urea breath test (UBT), fecal antigen test (FAT), and serology for diagnosis of H. pylori (...) costs and higher QALYs; the UBT was cost-effective vs serology (incremental cost/QALY gained $74).Based on a comprehensive modeled analysis that included consideration of patient test adherence and long-term consequences resulting from continuing H. pylori infection, the UBT provided the greatest economic value among noninvasivetests for diagnosis of H. pylori infection, because of high patient adherence and excellent test performance.
Cost-effectiveness analysis of universal noninvasivetesting for post-treatment confirmation of Helicobacterpylori eradication and the impact of patient adherence The treatment failure rate for Helicobacterpylori eradication therapy is ~20% due to poor patient compliance and increased antibiotic resistance. This analysis assessed the cost-effectiveness of universal post-treatment testing to confirm eradication of H. pylori infection in adults.Decision-analytic models evaluated the cost (...) , excess lifetime costs and reduced quality-adjusted life-years (QALYs) due to continuing H. pylori infection were considered in the model.Expected total costs per patient were higher for post-treatment testing (UBT: US$325.76; mFAT: US$242.12) vs no testing (US$182.41) in Model 1 and for UBT (US$336.75) vs mFAT (US$326.24) in Model 2. Expected QALYs gained per patient were 0.71 and 0.72 for UBT and mFAT, respectively, vs no testing (Model 1), and the same was 0.37 for UBT vs mFAT (Model 2
Characteristics of Helicobacterpylori-seropositive subjects according to the stool antigen test findings: a prospective study In countries with a higher risk of gastric atrophic gastritis, noninvasivetests are helpful for a more reliable diagnosis of Helicobacterpylori infection. The aim of this study was to evaluate the characteristics of seropositive subjects according to their stool H. pylori antigen test, serum pepsinogen (PG) assay, and endoscopic findings.Consecutive subjects who (...) visited Konkuk University Medical Center for upper gastrointestinal endoscopy for a regular check-up were included in a prospective setting if the serum anti-H. pylori immunoglobulin G assay was positive. A H. pylori antigen stool test was measured using a stool H. pylori antigen enzyme-linked immunosorbent assay kit on the same day as a serum PG assay and endoscopy.Of 318 seropositive subjects, 256 (80.5%) showed positive stool test findings. Subjects with a negative stool test result showed lower
Catholic University Collaborator: Hôpital Cochin Information provided by (Responsible Party): Lille Catholic University Study Details Study Description Go to Brief Summary: The diagnostic tests used to detect Helicobacterpylori (H. pylori) infection are either direct and invasive, as in culture, histology and the rapid urease test (RUT) or noninvasive, such as serology, the 13C-Urea breathe test or the stool antigen test. However, there is no single reference method to detect the H. pylori infection (...) Performances of a Fast Test for the Detection of HelicobacterPylori Antigens in Child Stool Performances of a Fast Test for the Detection of HelicobacterPylori Antigens in Child Stool - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more
The Evaluation of Diagnostic and Predictive Values of Helicobacterpylori Stool Antigen Test in Iranian Patients with Dyspepsia Iran, as a developing country, is experiencing high burdens of Helicobacterpylori (Hp)-associated non-communicable diseases. Hp stool antigen test (HpSA) is widely used as an inexpensive and feasible noninvasive method to diagnose Hp infection, instead of invasive approaches. The current study aimed at evaluating the diagnostic and predictive values of HpSA test (...) to age (r=0.213, P-value=0.034). Considering 0.385 as a cutoff point, the HpSA test had 80.4% sensitivity and 85.7% specificity.Based on cost-effectiveness of HpSA test, the current study findings corroborated the use of HpSA test to detect and follow-up patients with Hp infection, as an alternative method to detect Hp rather than invasive procedures.
Epidemiology, Diagnosis, and Risk Factors of Helicobacterpylori Infection in Children H. pylori infection is a global public health problem associated with some gastrointestinal diseases in children, especially in developing countries, since prevalence of H. pylori is low in the developed world. Both noninvasive (stool antigen test, urea breath test, and blood test) and invasive (histology, rapid urease test, and microbiological culture) tests have been utilized to detect H. pylori infection (...) aims to determine the gaps in the knowledge of the epidemiology, risk factors, and diagnostic tests of H. pylori infection among children. How to cite this article: Ozbey G, Hanafiah A. Epidemiology, Diagnosis, and Risk Factors of Helicobacterpylori Infection in Children. Euroasian J Hepato-Gastroenterol 2017;7(1):34-39.
antimicrobial susceptibility testing by both invasive and noninvasive means is crucial to accurately evaluate resistance rates for the optimization of both regional and personalized H. pylori treatment strategies. (...) Helicobacterpylori resistance to current therapies. Helicobacterpylori eradication rates have fallen in recent years, mainly because of the emergence of antibiotic-resistant infections. Indeed the WHO has recently designated clarithromycin-resistant H. pylori infection a high priority for antibiotic resistance research and development. This review aims to discuss the most up-to-date information on the methods to detect H. pylori antibiotic resistance, the recent data on resistance rates
Evaluation of Invasive and Noninvasive Methods for the Diagnosis of HelicobacterPylori Infection Objective: The present study was conducted to evaluate invasive and noninvasive diagnostic methods for detection
of Helicobacterpylori (H. pylori) in patients admitted with dyspeptic complaints and to compare sensitivities and
specificities. Method: Sets of four gastric biopsy specimens were obtained from a total of 126 patients included in the
study. The presence of H. pylori was determined (...) by invasive tests including culture, rapid urease test, polymerase chain
reaction (PCR) and histopathology. Among noninvasivetests, urea breath test, serological tests and enzyme-linked
immunosorbent assay (ELISA) were performed. Results: H. pylori was isolated in 79 (62.7%) gastric biopsy cultures,
whereas positivity was concluded for 105 (83.3%) patients by rapid urease test, for 106 (84.1%) by PCR, for 110
(87.3%) by histopathology, for 119 (94.4%) by urea breath test, and for 107 (84.9%) by ELISA
Usefulness of detection of clarithromycin-resistant Helicobacterpylori from fecal specimens for young adults treated with eradication therapy. To prevent Helicobacterpylori infection in the younger generation, it is necessary to investigate the prevalence of antibiotic-resistant H. pylori.The aim of this study was to evaluate the method of PCR-based sequencing to detect clarithromycin (CAM) resistance-associated mutations using fecal samples as a noninvasive method.DNA extracted from fecal (...) specimens and isolates from gastric biopsy specimens were collected from patients with H. pylori infection. Antibiotic resistance to CAM was analyzed by molecular and culture methods. The detection rates of CAM resistance-associated mutations (A2142C or A2143G) were compared before and after eradication therapy.With CAM resistance of H. pylori evaluated by antibiotic susceptibility test as a gold standard, the sensitivity and the specificity of gene mutation detection from fecal DNA were 80% and 84.8
elements in the differential diagnosis have been ruled out. H. pylori can be detected with noninvasive methods (13C-urea breathing test, stool antigen detection) and with invasive methods (histology, culture, rapid urease test). An important consideration for treatment is that primary clarithromycin resistance is common in many groups of patients; in Germany, its prevalence is now 10.9%. Primary treatment can be with either standard triple therapy (clarithromycin and amoxicillin or metronidazole (...) HelicobacterPylori Infection. Infection with Helicobacterpylori (H. pylori) is a major pathogenic factor for gastroduodenal ulcer disease and gastric carcinoma, as well as for other types of gastric and extragastric disease. As a result of changing epidemiologic conditions (e.g., immigration), changing resistance patterns with therapeutic implications, and new knowledge relating to the indications for pathogen eradication, the medical management of H. pylori is a dynamic process in need
Use of the Noninvasive Entero-test in the Detection of Helicobacterpylori in Children in an Endemic Area in Colombia. Gastric infection with Helicobacterpylori (H pylori), a strong risk factor for gastric cancer, is highly prevalent in children residing in the Colombian Andes. We aimed to validate the use of the Entero-test to culture and genotype H pylori strains from asymptomatic Colombian children.Children (ages 10-15 years, n = 110, 80 of which were H pylori positive by the urea breath (...) as a noninvasivetest to detect H pylori in asymptomatic children residing in high-risk areas for gastric cancer. Treatment of H pylori in children was associated with less virulent genotypes.
Diagnosis of Helicobacterpylori infection by invasive and noninvasivetests Although several invasive and noninvasivetests have been developed for the diagnosis of Helicobacterpylori infection, all of the tests have their limitations. We conducted a study to investigate and compare the suitability of rapid urease test (RUT), serology, histopathology and stool antigen tests with polymerase chain reaction (PCR) for detection of H. pylori, and correlate the diagnostic methods with PCR. Eighty (...) nine patients (61 adults, 28 children) referred to the Firoozgar Hospital and Children Medical Center Hospital for diagnostic upper gastrointestinal endoscopy entered to the study and noninvasivetests such as immunoassay for serological antibodies against H. pylori and detection of its antigen in feces were measured. The biopsies were utilized for histological examination, RUT and PCR. The H. pylori statuses were evaluated by the positivity of ureC PCR in biopsy specimens and 53 subjects had H
below the detection limit. CagA was particularly long lasting in both independent populations. An isolated CagA band often represents past eradication with a likelihood of 88.7%. In addition, a high recomLine score was significantly associated with high-grade gastritis, atrophy, intestinal metaplasia, and gastric cancer. Thus, the recomLine is a sensitive and specific noninvasivetest for detecting serum responses against H. pylori in actively infected and eradicated individuals. Moreover, it allows (...) Validation of a Novel Immunoline Assay for Patient Stratification according to Virulence of the Infecting Helicobacterpylori Strain and Eradication Status Helicobacterpylori infection shows a worldwide prevalence of around 50%. However, only a minority of infected individuals develop clinical symptoms or diseases. The presence of H. pylori virulence factors, such as CagA and VacA, has been associated with disease development, but assessment of virulence factor presence requires gastric