Urease activity does not reflect the degree of colonization by Helicobacter pylori in children.
BACKGROUND
Urea breath test is an accurate method for the diagnosis of Helicobacter pylori infection in children. This test could estimate the bacterial load by measuring the urease activity in gastric mucosa. The aim of the study was to correlate the result of 13C-urea breath test (13C-UBT) and histological estimative for bacterial colonization and severity of inflammatory infiltrate.


METHODS
Forty-four patients (mean age 8.54 +/- 3.9 years) with dyspeptic symptoms were evaluated. Patients were evaluated through endoscopy and 13C-UBT. Helicobacter pylori infection was defined by histology, rapid urease test and 13C-UBT. Breath test results were expressed by delta over baseline (DOB) and urea hydrolysis rate (UHR). Test results were treated logarithmically for statistical analysis.


RESULTS
There was a significant inverse correlation between age and Log DOB (-0.501, P= 0.0005), but there was no relationship between Log UHR and age (-0.148, P= 0.336). The study did not find correlation between the breath test result and histological grades for mononuclear infiltrate, neutrophilic infiltrate and bacterial density.


CONCLUSIONS
The 13C-UBT does not estimate the severity of histological findings in children with Helicobacter pylori infection. The results of the breath test should be interpreted in a qualitative way.
Machado
Rodrigo Strehl
RS
Department of Pediatrics, Pediatric Gastroenterology Division, Peptic Diseases Outpatient Clinic, Sao Paulo, Brazil. rodrigo@gastroped.epm.br
Kawakami
Elisabete
E
Da Silva Patrício
Francy Reis
FR
Reber
Marialice
M
D000293:Adolescent; D001431:Bacteriological Techniques; D001944:Breath Tests; D002247:Carbon Isotopes; D002648:Child; D002675:Child, Preschool; D005260:Female; D005756:Gastritis / Q000175:diagnosis*; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000201:enzymology*; D006651:Histocytochemistry; D006801:Humans; D007223:Infant; D008297:Male; D011706:Pyloric Antrum / Q000473:pathology; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014508:Urea; D014510:Urease / Q000378:metabolism*
D002247:Carbon Isotopes; D014508:Urea; D014510:Urease