Comparison of various Helicobacter pylori diagnostic techniques in samples isolated from Iraqi patients
DOI:
https://doi.org/10.60988/p.v37i2S.148Keywords:
Helicobacter pylori; urea breath test; S-Ag test; serology; endoscopy; non-invasive testAbstract
The Helicobacter pylori infection is a major global health concern, contributing to various gastrointestinal disorders, including gastritis, peptic ulcers, and gastric cancer. Disease management relies on the availability of both accurate and reliable diagnostic methods. This study evaluates and compares the diagnostic accuracy of three widely used non-invasive tests (the 13C-urea breath test or 13C-UBT, the stool antigen test, and serological testing) against endoscopy (as the gold standard) in Jood Specialist Lab in Hillah (Iraq) between February and December 2024. A total of 100 patients was included in this study, and specimens were inspected using each of the aforementioned tests. Results showed that the 13C-UBT had the highest sensitivity (98.9%) and specificity (76.9%), which makes it the best non-invasive test for the diagnosis of an H. pylori infection. Meanwhile, the stool antigen test exhibited a slight lower performance in both sensitivity (94.8%) and specificity (65.2%), while the serological testing exhibited the lowest specificity (24.5%), resulting in a greater frequency of false positives. These findings underscore the limitations of serological testing and reinforce 13C-UBT’s position as the method of choice for the non-invasive diagnosis of H. pylori infections in Iraqi patients.
References
Demiray E., Yilmaz O., Sarkis C., Soyturk M., Simsek I. Comparison of invasive methods and two different stool antigen tests for diagnosis of H. pylori infection in patients with gastric bleeding. World J. Gastroenterol. 12(26), 4206–4210, 2006. DOI: 10.3748/wjg.v12.i26.4206
Kabir S. Detection of Helicobacter pylori in faeces by culture, PCR and enzyme immunoassay. J. Med. Microbiol. 50(12), 1021–1029, 2001. DOI: 10.1099/0022-1317-50-12-1021
Osaki T., Mabe K., Hanawa T., Kamiya S. Urease-positive bacteria in the stomach induce a false-positive reaction in a urea breath test for diagnosis of Helicobacter pylori infection. J. Med. Microbiol. 57(pt7), 814–819, 2008. DOI: 10.1099/jmm.0.47768-0
McNulty C.A., Lehours P., Mégraud F. Diagnosis of Helicobacter pylori infection. Helicobacter 16(s1), 10–18, 2011. DOI: 10.1111/j.1523-5378.2011.00875.x
Mégraud F., Lehours P. Helicobacter pylori detection and antimicrobial susceptibility testing. Clin. Microbiol. Rev. 20(2), 280–322, 2007. DOI: 10.1128/CMR.00033-06
Howden C.W., Hunt R.H. Guidelines for the management of Helicobacter pylori infection. Ad Hoc Committee on Practice Parameters of the American College of Gastroenterology. Am. J. Gastroenterol. 93(12), 2330–2338, 1998. DOI: 10.1111/j.1572-0241.1998.00684.x
Nocon M., Kuhlmann A., Leodolter A., Roll S., Vauth C., Willich S.N., et al. Efficacy and cost-effectiveness of the 13C-urea breath test as the primary diagnostic investigation for the detection of Helicobacter pylori infection compared to invasive and non-invasive diagnostic tests. GMS Health Technol. Assess. 5, Doc14, 2009. DOI: 10.3205/hta000076
el-Zimaity H.M., Graham D.Y., al-Assi M.T., Malaty H., Karttunen T.J., Graham D.P., et al. Interobserver variation in the histopathological assessment of Helicobacter pylori gastritis. Hum. Pathol. 27(1), 35–41, 1996. DOI: 10.1016/s0046-8177(96)90135-5
Razaghi M., Boutorabi S.M., Mirjalili A., Norolahi S., Hashemi M., Jalalian M. Diagnosis of Helicobacter pylori infection by ELISA stool antigen and comparison with the other diagnostic methods. HealthMED 4(3), 545–551, 2010.
Erzin Y., Altun S., Dobrucali A., Aslan M., Erdamar S., Dirican A., et al. Comparison of two different stool antigen tests for the primary diagnosis of Helicobacter pylori infection in Turkish patients with dyspepsia. Helicobacter 9(6), 657–662, 2004. DOI: 10.1111/j.1083-4389.2004.00280.x
