Skip to main content
SpringerLink
Log in

Helicobacter pylori infection diagnosis in hospitalised elderly patients: the stool antigen test (HpSA) in comparison with other methods

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background and aims: Helicobacter pylori (Hp) infection prevalence increases with age. In elderly patients, who often do not collaborate and who are affected by multiple pathologies, worldwide-recognised invasive and non-invasive methods (histology and Urea Breath Test) are not easy to apply. A new test based on the detection of Hp antigens in the stool (HpSA test) is now available. The aim of our study was to evaluate the sensitivity and specificity of the HpSA test, and the interference of drugs (acid suppression, antibiotics) on test performance. Methods: Hp infection was detected by UBT, HpSA and histology in 122 hospitalised elderly subjects, divided into two groups according to therapy in the last month. Subjects were classified as being Hp-positive if two test results (histology and UBT) were positive, and Hp-negative if the same two test results were negative. Results: The sensitivity and specificity of the HpSA test compared with two tests (histology and UBT) were respectively 76 and 95%. In the group of patients who had not received drugs, the sensitivity and specificity of the HpSA test were respectively 76 and 96%. Instead, in the group of patients who had received pharmacological therapy, sensitivity and specificity values were respectively 67 and 100%. HpSA-positive patients had received acid suppression for 9.2±8.9 days, and false-negative patients for 27.2±9.9 days. Conclusions: The HpSA test is simple, inexpensive, and non-invasive for Hp detection, especially in elderly subjects with no compliance. It is influenced only after several days by therapy common in the elderly.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Sipponen P, Hyvarinen H, Seppala K, Blaser MJ. Pathogenesis of the transformation from gastritis to malignancy. Aliment Pharmacol Ther 1998; 12 (Suppl 1): 61–71.

    Article  PubMed  CAS  Google Scholar 

  2. Rokkas T, Ladas S, Raptis S. Gastric cancer. Curr Opin Gastroenterol 2000; 16 (Suppl 1): S19–22.

    Google Scholar 

  3. Pilotto A, Di Mario F, Malfertheiner P, Valerio G, Naccarato R. Upper gastrointestinal diseases in the elderly: report of a meeting held at Vicenza, Italy, on 20 March 1998. Eur J Gastroenterol Hepatol 1999; 11: 801–8.

    Article  PubMed  CAS  Google Scholar 

  4. Bellantani S, Grossi E, Domicini P, Tiribelli C. Epidemiologia e modalità di trasmissione della infezione da Helicobacter pylori. Recenti Prog Med 2000; 4: 171–4.

    Google Scholar 

  5. Pilotto A, Fabrello R, Franceschi M, et al. Helicobacter pylori infection in asymptomatic elderly subjects living at home or in a nursing home: effects on gastric function and nutritional status. Age Ageing 1996; 25: 245–9.

    Article  Google Scholar 

  6. Manes G, Balzano A, Iaquinto G, et al. Accuracy of the H. Pylori stool antigen test in the pre- and post-eradication assessment and in patients on omeoprazole treatment. Gut 2000; 47 (Suppl 1): A113.

    Google Scholar 

  7. Bravo LE, Realpe JL, Campo C, Mera R, Correa P. Effects of acid suppression and bismuth medications on the performance of diagnostic tests for Helicobacter pylori infection. Am J Gastroenterol 1999; 94: 2380–3.

    Article  PubMed  CAS  Google Scholar 

  8. Leodolter A, Dominguez-Munoz JE, von Arnim U, et al. Validity of a modified 13C-Urea Breath test for pre- and post-treatment diagnosis of Helicobacter pylori infection in the routine clinical setting. Am J Gastroenterol 1999; 98: 2100–4.

    Article  Google Scholar 

  9. Bianchi Porro G, Maconi G, Parente F. L’infezione da Helicobacter pylori: aggiornamento continuo. Vol. 2. Libreria Cortina 2000; 23–9.

  10. Cutler AF, Prasad VH. Long-term follow-up of Helicobacter pylori serology after successful eradication. Am J Gastroenterol 1996; 91: 85–8.

    PubMed  CAS  Google Scholar 

  11. Gisbert JP, Pajares JM. Diagnosis of Helicobacter pylori infection by stool antigen determination: a systematic review. Am J Gastroenterol 2001; 96: 2829–38.

    Article  PubMed  CAS  Google Scholar 

  12. Monteiro L, de Mascarel A, Barberis C, et al. What is the performance of the Premier Platinum HpSA test in comparison to other invasive tests for the detection of Helicobacter Pylori infection? Gastroenterology 1999; 116: A528.

    Google Scholar 

  13. Gallo N, Basso D, Zambon CF, et al. Diagnosis of Helicobacter pylori infection: comparison of techniques. Recenti Prog Med 2001; 92: 332–5.

    PubMed  CAS  Google Scholar 

  14. Pilotto A, Franceschi M, Rassu M, et al. Stool antigen test (HpSA) for detection of H. pylori infection in elderly subjects: comparison with serology and influence of concomitant treatments on diagnostic accuracy. Gut 2000; 47 (Suppl 1): A117.

    Google Scholar 

  15. Dixon MF, Genta RM, Yardley JH, et al. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston, 1994. Am J Surg Pathol 1996: 20: 1161–81.

    Article  PubMed  CAS  Google Scholar 

  16. De Boer WA, De Laat L, Megraud F. Diagnosis of Helicobacter pylori infection. Curr Opin Gastroenterol 2000; 16 (Suppl 1): S5–S10.

    Google Scholar 

  17. Chey WD, Woods M, Scheiman JM, Nostrant TT, DelValle J. Lansoprazole and ranitidine affect the accuracy of the 14C-urea breath test by a pH-dependent mechanism. Am J Gastroenterol 1997; 92: 446–50.

    PubMed  CAS  Google Scholar 

  18. Gisbert JP. A critical review of the diagnostic methods for Helicobacter pylori infection. Gastroenterol Hepatol 2000; 23: 135–43.

    PubMed  CAS  Google Scholar 

  19. Vaira D, Ricci C, Menegatti M, et al. Stool test for Helicobacter pylori. Am J Gastroenterol 2001; 96: 1935–8.

    Article  PubMed  CAS  Google Scholar 

  20. European Helicobacter pylori Study Group. Current European concepts in the management of Helicobacter pylori infection. The Maastricht Consensus Report. Gut 1997; 41: 8–13.

    Article  Google Scholar 

  21. Savarino V, Tracci D, Dulbecco P, et al. Negative effect of ranitidine on the results of Urea Breath test for the diagnosis of Helicobacter pylori. Am J Gastroenterol 2001; 96: 348–52.

    Article  PubMed  CAS  Google Scholar 

  22. Pilotto A, Franceschi M, Leandro G, et al. Noninvasive diagnosis of Helicobacter pylori infection in older subjects: comparison of the 13C-Urea Breath Test with serology. J Gerontol 2000; 55: M163–7.

    Article  CAS  Google Scholar 

  23. Iwahi T, Satoh H, Nakao M. Lansoprazole, a novel benzimidazole proton pump inhibitor, and its related compounds have selective activity against Helicobacter pylori. Antimicrob Agents Chemother 1991; 35: 490–6.

    Article  PubMed  CAS  Google Scholar 

  24. McGowan CC, Cover TL, Blaser MJ. The proton pump inhibitor omeprazole inhibits acid survival of Helicobacter pylori by a urease-independent mechanism. Gastroenterology 1994; 107: 1573–8.

    Article  PubMed  CAS  Google Scholar 

  25. Graham DY, Genta R, Evans DG, et al. Helicobacter pylori does not migrate from the antrum to the corpus in response to omeprazole. Am J Gastroenterol 1996; 91: 2120–4.

    PubMed  CAS  Google Scholar 

  26. Manes G, Balzano A, Iaquinto G, et al. Accuracy of stool antigen test in posteradication assessment of Helicobacter pylori infection. Dig Dis Sci 2001; 46: 2440–4.

    Article  PubMed  CAS  Google Scholar 

  27. Ohkura R, Miwa H, Murai T, et al. Usefulness of a novel enzyme immunoassay for the detection of Helicobacter pylori in feces. Scand J Gastroenterol 2000; 35: 49–53.

    Article  PubMed  CAS  Google Scholar 

  28. Makristathis A, Pasching E, Schutze K, et al. Detection of Helicobacter pylori in stool specimens by PCR and antigen enzyme immunoassay. J Clin Microbiol 1998; 36: 2772–4.

    PubMed  CAS  Google Scholar 

  29. Wang YL, Sheu BS, Huang JJ, Yang HB. Noninvasive stool antigen assay can effectively screen Helicobacter pylori infection and assess success of eradication therapy in hemodialysis patients. Am J Kidney Dis 2001; 38: 98–103.

    Article  PubMed  CAS  Google Scholar 

  30. Salvioli G, Mussi C. La definizione di paziente geriatrico. Giorn Geront 1999; 47 (Suppl. 1): 91–5.

    Google Scholar 

  31. Costa F, Mumolo MG, Bellini M, et al. Post-treatment diagnostic accuracy of a new enzyme immunoassay to detect Helicobacter pylori in stools. Aliment Pharmacol Ther 2001; 15: 395–401.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medical and Surgical Sciences, University of Padova, Clinica Geriatrica, Via Giustiniani 2, 35100, Padova, Italy

    Emine Meral Inelmen MD, Giuliano Enzi, Giulia Gasparini, Fabio Fuson, Barbara Davanzo, Francesca Tiozzo & Giuseppe Sergi

  2. Digestive Endoscopic Service, Ospedale Sant’Antonio, ULSS 16, Padova

    Tommaso Maccari & Fabio Ancona

  3. National Research Council, Institute of Neuroscience, Section on Aging, Padova, Italy

    Stefania Maggi

Authors
  1. Emine Meral Inelmen MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tommaso Maccari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giuliano Enzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Giulia Gasparini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fabio Fuson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Barbara Davanzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Francesca Tiozzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Fabio Ancona
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Giuseppe Sergi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Stefania Maggi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Emine Meral Inelmen MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Inelmen, E.M., Maccari, T., Enzi, G. et al. Helicobacter pylori infection diagnosis in hospitalised elderly patients: the stool antigen test (HpSA) in comparison with other methods. Aging Clin Exp Res 16, 349–355 (2004). https://doi.org/10.1007/BF03324563

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03324563

Key Words

Search

Navigation