title: High accuracy of noninvasive tests to diagnose Helicobacter pylori infection in very young children.
abstract: 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.
authors.affiliation: Pediatric Department, University of Piemonte Orientale, and Microbiology Laboratory "Maggiore della Carità" Hospital, Novara, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Dondi
authors.forename: Anna
authors.initials: A
authors.lastname: Rapa
authors.forename: Renzo
authors.initials: R
authors.lastname: Boldorini
authors.forename: Paola
authors.initials: P
authors.lastname: Fonio
authors.forename: Sara
authors.initials: S
authors.lastname: Zanetta
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Oderda
mesh_terms: 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
chemical_list: D000942:Antigens, Bacterial; D014508:Urea