Helicobacter pylori infection diagnosis in hospitalised elderly patients: the stool antigen test (HpSA) in comparison with other methods.
OBJECTIVE
Helicobacter pylori (Hp) infection prevalence increases with age. In elderly patients, who often do not collaborate and who are affected by multiple pathologies, worldwide-recognised invasive and non-invasive methods (histology and Urea Breath Test) are not easy to apply. A new test based on the detection of Hp antigens in the stool (HpSA test) is now available. The aim of our study was to evaluate the sensitivity and specificity of the HpSA test, and the interference of drugs (acid suppression, antibiotics) on test performance.


METHODS
Hp infection was detected by UBT, HpSA and histology in 122 hospitalised elderly subjects, divided into two groups according to therapy in the last month. Subjects were classified as being Hp-positive if two test results (histology and UBT) were positive, and Hp-negative if the same two test results were negative.


RESULTS
The sensitivity and specificity of the HpSA test compared with two tests (histology and UBT) were respectively 76 and 95%. In the group of patients who had not received drugs, the sensitivity and specificity of the HpSA test were respectively 76 and 96%. Instead, in the group of patients who had received pharmacological therapy, sensitivity and specificity values were respectively 67 and 100%. HpSA-positive patients had received acid suppression for 9.2 +/- 8.9 days, and false-negative patients for 27.2 +/- 9.9 days.


CONCLUSIONS
The HpSA test is simple, inexpensive, and non-invasive for Hp detection, especially in elderly subjects with no compliance. It is influenced only after several days by therapy common in the elderly.
Inelmen
Emine Meral
EM
Department of Medical and Surgical Sciences, University of Padova, Italy. eminemeral.inelmen@unipd.it
Maccari
Tommaso
T
Enzi
Giuliano
G
Gasparini
Giulia
G
Fuson
Fabio
F
Davanzo
Barbara
B
Tiozzo
Francesca
F
Ancona
Fabio
F
Sergi
Giuseppe
G
Maggi
Stefania
S
D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial / Q000032:analysis*; D001431:Bacteriological Techniques / Q000379:methods / Q000706:statistics & numerical data; D001944:Breath Tests / Q000379:methods; D005243:Feces / Q000382:microbiology; D005260:Female; D005756:Gastritis / Q000175:diagnosis / Q000382:microbiology; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology*; D006652:Histological Techniques / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D008297:Male; D012680:Sensitivity and Specificity; D014508:Urea
D000942:Antigens, Bacterial; D014508:Urea