title: Use of the noninvasive entero-test in the detection of Helicobacter pylori in children in an endemic area in Colombia.
abstract: OBJECTIVE
  Gastric infection with Helicobacter pylori (H pylori), a strong risk factor for gastric cancer, is highly prevalent in children residing in the Colombian Andes. We aimed to validate the use of the Entero-test to culture and genotype H pylori strains from asymptomatic Colombian children.
  
  
  METHODS
  Children (ages 10-15 years, n = 110, 80 of which were H pylori positive by the urea breath test [UBT]) were subjected to the Entero-test, and strings were cultured and/or used for DNA extraction for polymerase chain reaction (PCR). These children had been treated for H pylori in 2007. A second population of children (ages 10-15 years, n = 95),which had not been previously treated, was also subjected to the Entero-test.
  
  
  RESULTS
  Of UBT-positive children in the treated group, 29 of 80 (36%) Entero-test samples were H pylori culture positive; 29 additional string extracts were tested by PCR for the H pylori virulence factors cagA and vacA. PCR from cultures and extracts yielded a sensitivity of 74% and specificity of 87%. In the untreated group, 16 of 94 UBT-positive children (17%) produced Entero-tests that were culture positive. Fifty-eight of 94 (62%) string extracts were PCR positive for cagA and/or vacA. In previously treated children, H pylori strains were more often the less virulent vacA s2 (P = 0.001), m2 (P = 0.006), and i2 genotypes (P = 0.039).
  
  
  CONCLUSIONS
  The Entero-test may be used as a noninvasive test to detect H pylori in asymptomatic children residing in high-risk areas for gastric cancer. Treatment of H pylori in children was associated with less virulent genotypes.
authors.affiliation: Department of Medicine, Division of Gastroenterology, Vanderbilt University School of Medicine, Nashville, TN 37232 , USA.
authors.forename: Richard N
authors.initials: RN
authors.lastname: Arboleda
authors.forename: Barbara G
authors.initials: BG
authors.lastname: Schneider
authors.forename: Luis E
authors.initials: LE
authors.lastname: Bravo
authors.forename: Judith
authors.initials: J
authors.lastname: Romero-Gallo
authors.forename: Richard M
authors.initials: RM
authors.lastname: Peek
authors.forename: Robertino M
authors.initials: RM
authors.lastname: Mera
authors.forename: Maria Clara
authors.initials: MC
authors.lastname: Yepez
authors.forename: Cristina
authors.initials: C
authors.lastname: Campo
authors.forename: Pelayo
authors.initials: P
authors.lastname: Correa
mesh_terms: D000942:Antigens, Bacterial / Q000235:genetics*; D001426:Bacterial Proteins / Q000235:genetics*; D015373:Bacterial Typing Techniques; D001944:Breath Tests; D002648:Child; D003105:Colombia / Q000453:epidemiology; D004269:DNA, Bacterial; D019353:Endemic Diseases; D005260:Female; D005838:Genotype; D016481:Helicobacter Infections / Q000453:epidemiology / Q000382:microbiology*; D016480:Helicobacter pylori / Q000235:genetics* / Q000472:pathogenicity; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000382:microbiology*; D037521:Virulence Factors / Q000235:genetics*
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D004269:DNA, Bacterial; C074689:VacA protein, Helicobacter pylori; D037521:Virulence Factors; C080866:cagA protein, Helicobacter pylori