Evaluation of a rapid new stool antigen test for diagnosis of Helicobacter pylori infection in adult patients
Abstract number: 1734_114
Krausse R., Müller G., Doniec M.
The overall objective of this study was to evaluate the performance of a rapid new stool antigen test (Rapid Hp StARTM, Dako) for the diagnosis of a H. pylori infection in adult patients in our region. The accuracy of the test was defined in relation to the different clinical entities and to the age of the patients. The study included 72 dyspeptic adult patients (37 women, 35 men, mean age 58.4±15 years, range 2488 years) and was conducted in the years 2002 and 2003. Biopsies were taken for culture, histology and/or rapid urease test. Out of 72 patients, 28 (38.9%) were H. pylori positive, 44 (61.1%) were H. pylori negative. 18 (64.3%) of the 28 H. pylori positive patients had gastritis (n = 11, 39.3%) or gastroduodenal ulcers (GDU) (n = 7, 25.0%) and all other (n = 10, 35.7%) patients had a normal mucosa (NM). Gastritis, GDU and NM were determined in 11 (25.0%), 2 (4.5%) and 31 (70.5%) of the Hp negative patients. Faecal specimens were collected from all the patients and examined for the presence of H. pylori. The Rapid Hp StARTM stool antigen test yielded positive results in 13 and 20 of the 28 H. pylori-positive patients (46.4 and 71.4%) after a reading time of 20 and 30 min, respectively. Within the H. pylori-negative group of patients (n = 44) the test identified 2 (4.5%), and 7 (15.9%) as H. pylori positive after 20 and 30 min, respectively. The sensitivity, specificity, positive and negative predictive value and accuracy were 59.1%, 93.1%, 86.7%, 75.0% and 78.4% after a reading time of 20 min and 76.9%, 82.9%, 74.1%, 85.0% and 80.6% after 30 min. The test achieved the highest sensitivity and specificity among the patients with duodenal ulcers, followed by patients with normal mucosa and gastritis. Moreover, the age (<45 vs > 45 years) and the gender of the patients influenced the efficiency of the test.
Conclusion: This new monoclonal rapid stool antigen test can be used as an alternative non-invasive method to detect H. pylori infection. However, a longer incubation time (30 min) is recommended when negative results occur within 20 min; further studies with a greater number of different patient groups are required to confirm its accuracy.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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