13 C-urea breath test with infrared spectroscopy for diagnosing helicobacter pylori infection in children and adolescents.
OBJECTIVE
Studies support the accuracy of 13C-urea breath test for diagnosing and confirming cure of Helicobacter pylori infection in children. Three methods are used to assess 13CO2 increment in expired air: mass spectrometry, infrared spectroscopy, and laser-assisted ratio analysis. In this study, the 13C-urea breath test performed with infrared spectroscopy in children and adolescents was evaluated.


METHODS
Seventy-five patients (6 months to 18 years old) were included. The gold standard for diagnosis was a positive culture or positive histology and a positive rapid urease test. Tests were performed with 50 mg of 13C-urea diluted in 100 mL orange juice in subjects weighing up to 30 kg, or with 75 mg of 13C-urea diluted in 200 mL commercial orange juice for subjects weighing more than 30 kg. Breath samples were collected just before and at 30 minutes after tracer ingestion. The 13C-urea breath test was considered positive when delta over baseline (DOB) was greater than 4.0%.


RESULTS
Tests were positive for H. pylori in 31 of 75 patients. Sensitivity was 96.8%, specificity was 93.2%, positive predictive value was 90.9%, negative predictive value was 97.6%, and accuracy was 94.7%.


CONCLUSIONS
13C-urea breath test performed with infrared spectroscopy is a reliable, accurate, and noninvasive diagnostic tool for detecting H. pylori infection.
Kawakami
Elisabete
E
Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil. elkawakami.dped@epm.br
Machado
Rodrigo Strehl
RS
Reber
Marialice
M
Patrício
Francy Reis S
FR
D000293:Adolescent; D001944:Breath Tests; D002247:Carbon Isotopes; D002648:Child; D002675:Child, Preschool; D005260:Female; D005756:Gastritis / Q000382:microbiology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori; D006801:Humans; D007223:Infant; D008297:Male; D010437:Peptic Ulcer / Q000382:microbiology; D012680:Sensitivity and Specificity; D013055:Spectrophotometry, Infrared; D014508:Urea / Q000008:administration & dosage; D014510:Urease / Q000032:analysis
D002247:Carbon Isotopes; D014508:Urea; D014510:Urease