title: Accuracy of invasive and noninvasive tests to diagnose Helicobacter pylori infection after antibiotic treatment.
abstract: OBJECTIVE
  To compare the diagnostic accuracy of the most widely available tests for diagnosis of Helicobacter pylori infection after antibiotic treatment.
  
  
  METHODS
  A total of 59 H. pylori-positive, duodenal ulcer patients (mean age, 40.7 +/- 11.7 yr; 40 male and 19 female) were treated for 2 wk with either amoxicillin-metronidazole (n = 36) or omeprazole-amoxicillin-tinidazole (n = 23), and after 4 wk, were tested for H. pylori infection by [14C]urea breath test (UBT), serum IgG antibody level, and multiple antral biopsies for rapid urease testing, histology, Warthin-Starry stain, and polymerase chain reaction to detect H. pylori DNA. Infection status was established by a concordance of test results.
  
  
  RESULTS
  H. pylori was eradicated in 47 patients (80%). UBT and rapid urease testing had the best sensitivity and specificity, although not statistically different to Warthin-Starry stain and polymerase chain reaction. Serology and histology had little diagnostic value in this setting due to high proportion of false-positive results.
  
  
  CONCLUSIONS
  Noninvasive UBT is as accurate in predicting H. pylori status after antibiotic treatment as rapid urease testing and Warthin-Starry stain. Especially for duodenal ulcer patients, UBT could be considered the gold standard to confirm eradication of H. pylori.
authors.affiliation: Gastroenterology Department, Centro de Investigaciones Médicas, Faculty of Medicine, Catholic University of Chile, Santiago.
authors.forename: A
authors.initials: A
authors.lastname: Rollán
authors.forename: R
authors.initials: R
authors.lastname: Giancaspero
authors.forename: M
authors.initials: M
authors.lastname: Arrese
authors.forename: C
authors.initials: C
authors.lastname: Figueroa
authors.forename: V
authors.initials: V
authors.lastname: Vollrath
authors.forename: M
authors.initials: M
authors.lastname: Schultz
authors.forename: I
authors.initials: I
authors.lastname: Duarte
authors.forename: P
authors.initials: P
authors.lastname: Vial
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001944:Breath Tests; D004381:Duodenal Ulcer / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014510:Urease / Q000032:analysis
chemical_list: D000900:Anti-Bacterial Agents; D014510:Urease