title: Helicobacter Pylori Infection: Diagnostic Strategies in Primary Diagnosis and After Therapy.
abstract: Accurate diagnosis of Helicobacter pylori infection pre- and post-treatment is mandatory in the current era of decreasing prevalence and increasing antibiotic resistance. The diagnostic performance of most tests is poorer in clinical situations with low bacterial density which is seen in conditions such as atrophic gastritis or intake of antisecretory and antibiotic medications. Noninvasive tests require less cost and resource but provide excellent accuracy; however, endoscopy with testing of gastric biopsy specimens is indicated where alarming symptoms are present or antibiotic susceptibility testing by culture is desired. Newer modalities such as polymerase chain reaction testing provide additional virulence and antibiotic sensitivity profiling. This article outlines new developments and the key parameters of each test, as careful selection of test modality within the clinical context is required for adequate management of infected symptomatic patients.
authors.affiliation: Translational Gastroenterology Unit, Oxford University Hospitals NHS Trust, Headley Way, Oxford, OX3 9DU, UK.
authors.forename: Nathan S S
authors.initials: NS
authors.lastname: Atkinson
authors.affiliation: Translational Gastroenterology Unit, Oxford University Hospitals NHS Trust, Headley Way, Oxford, OX3 9DU, UK. braden@em.uni-frankfurt.de.
authors.forename: Barbara
authors.identifier: http://orcid.org/0000-0002-8534-6873
authors.initials: B
authors.lastname: Braden
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial / Q000032:analysis; D001426:Bacterial Proteins / Q000032:analysis; D001431:Bacteriological Techniques; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D001944:Breath Tests; D016099:Endoscopy, Gastrointestinal; D005243:Feces / Q000382:microbiology; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects / Q000201:enzymology / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D011237:Predictive Value of Tests; D012698:Serologic Tests; D016896:Treatment Outcome; D014510:Urease / Q000032:analysis
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D015415:Biomarkers; D007074:Immunoglobulin G; D014510:Urease
keywords: Endoscopy; Eradication; Helicobacter pylori infection; Histology; Polymerase chain reaction; Rapid urease test; Serology; Stool antigen test; Urea breath test