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Detection of Helicobacter pylori organisms by Hp-fast in children
1Department of Pediatrics, Pediatric Gastroenterology, Marshall University School of Medicine, Huntington, West Virginia 25701-0195, USA.
Insights
The Hp-fast test shows comparable results to the CLOtest for detecting H. pylori in children. However, neither rapid urease test alone is sufficient for diagnosis, highlighting the need for combined diagnostic approaches.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Diagnostic Microbiology
Background:
- Helicobacter pylori (H. pylori) infection is a common cause of gastritis in children.
- Rapid urease tests (RUTs) are used for H. pylori detection, but the newer Hp-fast has not been evaluated in pediatric populations.
- Accurate diagnosis is crucial for effective treatment and management of H. pylori-related gastrointestinal symptoms.
Purpose of the Study:
- To prospectively compare the diagnostic performance of the Hp-fast test against the CLOtest in children.
- To evaluate the concordance between Hp-fast, CLOtest, and histological findings.
- To determine the optimal gold standard for H. pylori diagnosis in pediatric patients.
Main Methods:
- Prospective enrollment of children with gastrointestinal symptoms undergoing upper endoscopy.
- Collection of antral gastric biopsies for histology, CLO-test, and Hp-fast analysis.
- Comparison of RUT results with histological confirmation and serological data.
Main Results:
- The study included 94 children; gastritis was present in 38 (40%), with H. pylori identified in 16 (42%) of those cases.
- Hp-fast and CLOtest demonstrated high concordance (98%).
- The accuracy of both RUTs improved significantly when histology and serology were combined as the gold standard, yielding 100% sensitivity.
Conclusions:
- Hp-fast is a reliable alternative to CLOtest for H. pylori detection in children.
- Neither Hp-fast nor CLOtest alone is adequate for definitive H. pylori diagnosis in this age group.
- Combined diagnostic strategies, including histology and serology, enhance diagnostic accuracy for H. pylori infection in children.
Abstract:
Hp-fast is a new rapid urease test (RUT) that has not been evaluated in children. The aim of the study was to prospectively compare the Hp-fast test to the CLOtest in children. Children with gastrointestinal symptoms who undergo diagnostic upper endoscopy were prospectively enrolled to the study. Antral gastric biopsies were evaluated for histology and for CLO-test and Hp-fast. Results were then compared to histology. Of the 94 children who participated, gastritis was found in 38 (40%), of whom 16 (42%) had associated H. pylori organisms. In two children, H. pylori organisms were identified without gastritis. The concordance between both RUT tests was 98%. A significant correlation was found between RUT results and histological factors or serology. The accuracy rate of both RUT increased significantly when different gold standards were utilized to detect Hp infection in children. The best correlation was found when histology and serology were considered as the gold standard for the diagnosis of H. pylori infection in children (sensitivity: 100% compared to 43-80% with other standards, respectively). In conclusion, the Hp-fast test result is comparable to CLOtest, but neither alone is sufficient to establish the diagnosis of Hp infection in children.