Detection of Helicobacter pylori in stool specimens: comparative evaluation of nested PCR and antigen detection.
BACKGROUND
Efficacy of Helicobacter pylori stool antigen enzyme immunoassay (HpSA) and stool PCR was evaluated, before and after treatment, in a country with a high prevalence of H. pylori infection.


METHODS
A total of 52 patients with dyspeptic symptoms were included in the study. Antral biopsy was collected during pre- and post-therapy periods for rapid urease test (RUT) and PCR. Similarly stool specimens for PCR and HpSA test were collected during both the periods from all 52 patients. Biopsy, PCR and RUT results together were considered the "gold standard."


RESULTS
On the basis of gold standard tests, 40/52 patients were H. pylori positive. The sensitivity and specificity of HpSA test were 80% and 83.3% respectively in untreated patients. On the other hand, the sensitivity and specificity of stool PCR in untreated patients were 72.5% and 100% respectively. After eradication therapy, the results of both RUT and biopsy PCR were negative in 87.5% and positive in 12.5% of the patients. Although post treatment sensitivity of HpSA and stool PCR was equal (60%), specificity of HpSA and stool PCR were 68.6% and 97.1% respectively.


CONCLUSIONS
The H. pylori stool tests represent a non-invasive concept for diagnosis of infection. Both HpSA and stool PCR seem to be satisfactory tests for pre-eradication as well as assessment of infection. But stool PCR is a better indicator than HpSA test in the post-eradication assessment of infection.
Mishra
Shrutkirti
S
Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, India.
Singh
Varsha
V
Rao
G R Koteswar
GR
Jain
Ashok Kumar
AK
Dixit
Vinod Kumar
VK
Gulati
Anil Kumar
AK
Nath
Gopal
G
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000942:Antigens, Bacterial / Q000276:immunology / Q000302:isolation & purification*; D001706:Biopsy; D004269:DNA, Bacterial / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology*; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D016480:Helicobacter pylori / Q000187:drug effects / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011706:Pyloric Antrum / Q000473:pathology; D012680:Sensitivity and Specificity
D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D004269:DNA, Bacterial