13C-urea breath test to diagnose Helicobacter pylori infection in children aged up to 6 years.
BACKGROUND
13C-urea breath test (13C-UBT) is an accurate noninvasive tool for diagnosis of Helicobacter pylori infection. It is considered the best method for epidemiological studies, but there are few studies to evaluate the 13C-UBT in infants and toddlers.


OBJECTIVE
To evaluate the 13C-UBT performed with infrared spectroscopy in children aged up to 6 years.


METHODS
Sixty-eight patients (6 months. to 5 years 11 months.) were evaluated prospectively and consecutively.


METHODS
Helicobacter pylori infection was detected by positive culture, or rapid urease test and histological examination, both positive. 13C-UBT was performed with 50 mg of 13C-urea diluted in 100 ml of commercial orange juice. Two expired air samples were collected: before and 30 minutes after tracer ingestion. Cutoff of delta over baseline (DOB) was 4.0 per thousand and urea hydrolysis rate 10 microg/minute.


RESULTS
Fifteen of 68 (22.1%) patients were H. pylori infected. Sensitivity was 93.3% (95% CI; 86.8%-99.7%) and specificity was 96.2% (95% CI; 93.6%-98.8%), and these values were equal for DOB and urea hydrolysis rate. Negative DOB values in noninfected patients ranged from -1.5 per thousand to 2.6 per thousand and positive DOB values ranged from 10.8 per thousand to 105.5 per thousand. There was no relationship between DOB values and age. Conclusion. 13C-UBT performed with infrared spectroscopy proved to be a reliable and accurate noninvasive diagnostic tool for H. pylori infection detection in children aged up to 6 years. Results far from cutoff value can clearly distinguish positive from negative 13C-UBT results in children up to 6 years old.
Machado
Rodrigo Strehl
RS
Department of Pediatrics, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil.
Patrício
Francy Reis da Silva
FR
Kawakami
Elisabete
E
D001706:Biopsy; D001944:Breath Tests; D002247:Carbon Isotopes / Q000032:analysis* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005753:Gastric Mucosa / Q000473:pathology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000254:growth & development / Q000302:isolation & purification / Q000378:metabolism*; D006801:Humans; D007223:Infant; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013057:Spectrum Analysis; D014508:Urea / Q000378:metabolism*
D002247:Carbon Isotopes; D014508:Urea