Evaluation of the Stool Antigen Test for Helicobacter pylori in Children and Adolescents
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The stool antigen test for Helicobacter pylori is a noninvasive immunoassay to diagnose active infection with Helicobacter pylori in human fecal samples. Its performance in children and teenagers has been tested in some developed countries, showing a sensitivity and specificity above 90%, however, its accuracy in developing countries and in children under 6 years is not well established. To determine the accuracy of the test for diagnosing Helicobacter pylori infection in children and teenagers, we evaluated 133 patients (4 months to 17 years old). The gold standard was a positive culture or positive histology and rapid urease test. The test was done according to the manufacturer’s instructions. However, modifications were introduced for better reproducibility. Samples were analyzed twice and results are expressed as optical density (OD) determined spectrophotometrically at 450 nm. HpSA was considered positive at OD ≥0.160 and negative at OD < 0.140. One hundred twenty-seven of the 133 (95.5%) patients were included. There were no infected infants. The test showed a 94.6% sensitivity (95% CI: 90.6–98.5) and a 96.5% specificity (95% CI: 93.3–99.7). At ages 2 to 6 years the specificity was 96.4% (95% CI: 85.1–99.2) and the sensitivity was 80.0% (95% CI: 64.8–89.7), at ages 6 to 10 years the sensitivity was 100.0% and the specificity 95.7%, and above 10 years the sensitivity and specificity were 100.0%. We conclude that the test is efficient in adolescents and children, however there is a need for further studies with a greater number of patients for evaluation of its accuracy in infants.
Keywords:Helicobacter pylori HpSA test stool children adolescents
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- 14.Ohkura R, Miwa H, Murai T, Miyake K, Sato N: Usefulness of Helicobacter pylori stool antigen (HpSA) assay for detection of Helicobacter pylori infection. Japan Consumers J 95(12):1397, 1998Google Scholar
- 17.Trevisani L, Sartori S, Galvani F, et al.: Evaluation of a new enzyme immunoassay for detecting Helicobacter pylori in feces: a prospective pilot study. Am J Gastroenterol 94(7):1831–1833, 1999Google Scholar
- 23.Vaira D, Ricci C, Menegatti M, et al.: Diagnosis of Helicobacter pylori infection: faecal antigen determination. In Helicobacter pylori: Basic Mechanisms to Clinical Cure 2000. Hunt RH, Tytgat GNJ (eds). Dordrecht, Kluwer Academic, 2000, p 115–22cGoogle Scholar
- 26.Katsiyiannakis E, Giannaki M, Mirilla I, et al.: Antigen enzyme immunoassay in stool specimen for diagnosis and monitoring of Helicobacter pylori (Hp) infection in children. In World Congress of Pediatric Gastroenterology, Hepatology and Nutrition, Boston August 5–9, 2000, p 574Google Scholar
- 29.Husson MO, Rolland C, Gottrand F, et al.: Evaluation of a Helicobacter pylori stool antigen test for the diagnosis and follow-up of infections in children. Eur J Microbiol Infect Dis 19:787–789, 2000 [note]Google Scholar
- 30.Katsiyiannakis E, Giannaki M, Mirilla I, et al.: Antigen enzyme immunoassay in stool specimen for diagnosis and monitoring of Helicobacter pylori (Hp) infection in children. In World Congress of Pediatric Gastroenterology, Hepatology and Nutrition, Boston, August 5–9, 2000, p 574Google Scholar
- 36.Rolland C, Kalach N, Spyckerelle C, Ganga-Zandzou PS, Gottrand F: Evaluation of the performance of Helicobacter pylori stool antigen test for the diagnosis and follow-up of infection in childhood. In World Congress of Pediatric Gastroenterology, Hepatology and Nutrition, Boston, August 5–9, 2000, p 588Google Scholar
- 43.Engevall E, Perlmann P: Enzyme-linked immunosorbent assay, ELISA. III. Quantitation of specific antibodies by enzyme-labeled anti-immunoglobulin in antigen-coated tubes. J Immunol 109(1):129–135, 1972Google Scholar
- 47.Kamiya S, Ohsaki K, Yamaguchi H, Taguchi Y: The specificity of H. pylori detection kit (HpSA) for stool specimen and reactivity with its coccoid form. In The Conference of Gastroenterology, Japan, 1999Google Scholar