title: Limitations of urease test in diagnosis of pediatric Helicobacter pylori infection.
abstract: The diagnosis of Helicobacter pylori (H. pylori) infection is usually based on the results of urease test and histology. The urease test known as a simple and cheap method does not need special skills to perform or to read the result. The time needed for the test to turn positive depends on the concentration of bacteria, and the accuracy is up to the density of H. pylori density in the biopsy sample, which is generally lower in children than adolescents and adults. Therefore, there are debates about the sensitivity of the urease test in children. The reason for lower sensitivity of the urease test in children was not identified, but might be related to the low density and patchy distribution of bacteria. In this review, we discuss the limitations of the urease test in children according to age, histology, number of biopsy samples, and biopsy site. In children under 5 years old, the differences in positivity rate when the urease test used one or three biopsy samples, and samples from the antrum or the gastric body, were larger than those in children aged 5-15 years. Thus, three or more biopsy samples from both the antrum and body would improve the sensitivity of H. pylori infection diagnosis in children under 5 years old.
authors.affiliation: Ji-Hyun Seo, Ji Sook Park, Hee-Shang Youn, Department of Pediatrics, Gyeongsang National Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju 52727, South Korea.
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Seo
authors.affiliation: Ji-Hyun Seo, Ji Sook Park, Hee-Shang Youn, Department of Pediatrics, Gyeongsang National Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju 52727, South Korea.
authors.forename: Ji Sook
authors.initials: JS
authors.lastname: Park
authors.affiliation: Ji-Hyun Seo, Ji Sook Park, Hee-Shang Youn, Department of Pediatrics, Gyeongsang National Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju 52727, South Korea.
authors.forename: Kwang Ho
authors.initials: KH
authors.lastname: Rhee
authors.affiliation: Ji-Hyun Seo, Ji Sook Park, Hee-Shang Youn, Department of Pediatrics, Gyeongsang National Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju 52727, South Korea.
authors.forename: Hee-Shang
authors.initials: HS
authors.lastname: Youn
keywords: Children; Helicobacter pylori infection; Urease test