High accuracy of noninvasive tests to diagnose Helicobacter pylori infection in very young children.
OBJECTIVE
To validate the (13)C-urea-breath-test (UBT) and stool antigen test (HpSA) in children aged 5 years or younger, against invasive histologic study and rapid-urease-testing or culture.


METHODS
On all consecutive children aged 5 years or younger undergoing endoscopy in 1 single center during the last 7.5 years, UBT and HpSA were performed.


RESULTS
Of a total of 184 children (median age 2.2 years, range 0.2-5.5), 30 were Helicobacter pylori-positive (16.3%). Sensitivity and specificity of UBT were 93.3% (95%CI 77.9%-99.2%) and 95.5% (90.9-98.2), with a cutoff of 5 per thousand, but specificity increased to 98.1% (94.4%-99.6%) with a cutoff of 8 per thousand. Sensitivity and specificity of HpSA were 93.3% (77.9%-99.2%) and 98.7% (95.4%-99.8%).


CONCLUSIONS
Accuracy of noninvasive tests in our single-center study were satisfactory: specificity of UBT improved with a cutoff at 8%, and sensitivity of HpSA was high when determined locally without transportation after long or inadequate storage that could impair results.
Dondi
Elena
E
Pediatric Department, University of Piemonte Orientale, and Microbiology Laboratory "Maggiore della Carità" Hospital, Novara, Italy.
Rapa
Anna
A
Boldorini
Renzo
R
Fonio
Paola
P
Zanetta
Sara
S
Oderda
Giuseppina
G
D000367:Age Factors; D000942:Antigens, Bacterial / Q000032:analysis*; D001944:Breath Tests; D002675:Child, Preschool; D005188:False Negative Reactions; D005189:False Positive Reactions; D005243:Feces / Q000737:chemistry*; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007223:Infant; D008297:Male; D015203:Reproducibility of Results; D014508:Urea / Q000032:analysis
D000942:Antigens, Bacterial; D014508:Urea