共查询到20条相似文献,搜索用时 0 毫秒
1.
Posttreatment Follow-Up of Helicobacter pylori Infection Using a Stool Antigen Immunoassay 下载免费PDF全文
Daniel E. Roth David N. Taylor Robert H. Gilman Rina Meza Uriel Katz Christian Bautista Lilia Cabrera Billie Velapatio Carlos Lebron Manuel Razúri J. Watanabe T. Monath The Gastrointestinal Physiology Working Group 《Clinical and Vaccine Immunology : CVI》2001,8(4):718-723
The Helicobacter pylori stool antigen enzyme immunoassay (HpSA) was evaluated during posttreatment follow-up of patients in a country with a very high prevalence of H. pylori infection. From among 273 dyspeptic individuals (18 to 55 years) initially recruited from a shantytown in Lima, Peru, 238 participants who met the inclusion criteria and were suspected to be H. pylori positive based on 14C urea breath test (UBT) results underwent endoscopy. Participants with endoscopy-proven infections received standard eradication therapy and were monitored by UBT and HpSA at 1 month following treatment and at 3-month intervals for 9 months posttreatment. A second endoscopy was performed if UBT results showed evidence of treatment failure or H. pylori recurrence. Biopsy results were considered the “gold standard” in all analyses. Among patients who underwent endoscopy, HpSA had a pretreatment sensitivity of 93%. Two-hundred thirty patients completed the treatment regimen, of whom 201 (93%) were considered to have had successful treatment outcomes based on a negative follow-up UBT. Thirty-two patients with UBT-defined treatment failures or H. pylori recurrences at any point during the 9-month follow-up underwent a second endoscopy. In the posttreatment setting, HpSA had an overall sensitivity of 73% and a specificity of 67%. Agreement between UBT and HpSA diminished throughout the follow-up. Among 14 participants in whom HpSA remained positive at 1 month following treatment despite UBT evidence of treatment success, 12 (86%) became HpSA negative within 3 months posttreatment. Although this study confirmed the validity of the HpSA in the initial assessment of dyspeptic patients, the test demonstrated a reduced overall accuracy in the detection of treatment failures and H. pylori recurrences during 9 months of posttreatment follow-up. Furthermore, in some patients it may take up to 3 months after successful eradication for antigen shedding to diminish to levels within the negative HpSA range. 相似文献
2.
M. O. Husson C. Rolland F. Gottrand D. Guimber N. Kalach C. Spyckerelle C. Lenaerts P. S. Ganga-Zandzou 《European journal of clinical microbiology & infectious diseases》2000,19(10):787-789
The aim of this study was to evaluate the performance of a newly developed enzyme immunoassay kit (HpSA) for detecting Helicobacter pylori antigens in the stool of children. This study was comprised of 58 children referred to various endoscopy units for evaluation
of gastrointestinal symptoms and upper gastroduodenal endoscopy and 11 children for post-therapy follow-up. In the first group,
23 children were diagnosed as positive for Helicobacter pylori using bacteriological and/or histological methods. Stool antigens were detected in 20 of these positive patients, for a sensitivity
of 86.9% and a negative predictive value of 91.9%. Since only one false-positive reaction was observed with the HpSA kit,
the specificity was 97.1% and the positive predictive value 95.2%. Results obtained for post-therapy follow-up were also promising.
The HpSA assays were negative for the eight children whose infections were eradicated after therapy, and a positive result
was obtained for two of three patients who had a persistent infection. 相似文献
3.
Dulciene Maria Magalh?es Queiroz Mayuko Saito Gifone Aguiar Rocha Andreia Maria Camargos Rocha Fabrício Freire Melo William Checkley Lúcia Libanez Bessa C. Braga Igor Sim?es Silva Robert H. Gilman Jean E. Crabtree 《Journal of clinical microbiology》2013,51(11):3735-3740
Accurate noninvasive tests for diagnosing Helicobacter pylori infection in very young children are strongly required. We investigated the agreement between the [13C]urea breath test ([13C]UBT) and a monoclonal ELISA (HpSA) for detection of H. pylori antigen in stool. From October 2007 to July 2011, we enrolled 414 infants (123 from Brazil and 291 from Peru) of ages 6 to 30 months. Breath and stool samples were obtained at intervals of at least 3 months from Brazilian (n = 415) and Peruvian (n = 908) infants. [13C]UBT and stool test results concurred with each other in 1,255 (94.86%) cases (kappa coefficient = 0.90; 95% confidence interval [CI] = 0.87 to 0.92). In the H. pylori-positive group, delta-over-baseline (DOB) and optical density (OD) values were positively correlated (r = 0.62; P < 0.001). The positivity of the tests was higher (P < 0.001; odds ratio [OR] = 6.01; 95% CI = 4.50 to 8.04) in Peru (546/878; 62.2%) than in Brazil (81/377; 21.5%) and increased with increasing age in Brazil (P = 0.02), whereas in Peru it decreased with increasing age (P < 0.001). The disagreement between the test results was associated with birth in Brazil and female gender but not with age and diarrhea. Our results suggest that both [13C]UBT and the stool monoclonal test are reliable for diagnosing H. pylori infection in very young children, which will facilitate robust epidemiological studies in infants and toddlers. 相似文献
4.
Application of a stool antigen test to evaluate the incidence of Helicobacter pylori infection in children and adolescents from Tehran, Iran 总被引:2,自引:0,他引:2
Falsafi T Valizadeh N Sepehr S Najafi M 《Clinical and diagnostic laboratory immunology》2005,12(9):1094-1097
Helicobacter pylori infection is acquired mainly in childhood, especially in developing countries, where a low-cost, rapid diagnostic technique which is reliable for all age groups may be useful for the management of H. pylori infection. For this purpose, we used an HpSA test (Equipar) to detect H. pylori infection in children and adolescents from Tehran, Iran. Thirty-five children who were positive or negative for H. pylori infection by endoscopy-based tests were used as positive and negative controls for the HpSA test. Stools were collected from 430 randomly selected children and adolescents (4 to 18 years old) from southwest, near the center, and northwest of Tehran. A questionnaire that included presence of recurrent abdominal pain (RAP), family history of infection and/or peptic ulcer disease (PUD), and income of parents was completed. A good agreement was found between the results of endoscopy-based tests and those of the HpSA test; the sensitivity and specificity of the Equipar-HpSA test were 100% and 83.4%, respectively. Among 430 children and adolescents, 47% were positive by the HpSA test, of whom 82% had RAP. No difference in incidence was observed between the two sexes; the various categories of age showed an increasing incidence, ranging from 24% (ages 4 to 6) to 58% (ages 16 to 18). The rate of infection in children and adolescents from the southwest was significantly higher (70%) than the rate in those from the northwest (32%), and a family history of H. pylori infection or PUD was observed in 59% of the HpSA positive subjects. The HpSA test is a useful test to detect H. pylori infection in children and adolescents from developing countries. 相似文献
5.
Detection of Helicobacter pylori in Stool Specimens by PCR and Antigen Enzyme Immunoassay 总被引:18,自引:0,他引:18 下载免费PDF全文
Athanasios Makristathis Eva Pasching Kurt Schütze Margit Wimmer Manfred L. Rotter Alexander M. Hirschl 《Journal of clinical microbiology》1998,36(9):2772-2774
A highly sensitive seminested PCR assay to detect Helicobacter pylori DNA in feces was developed. PCR with stool specimens and a novel antigen enzyme immunoassay (EIA) for H. pylori detection in feces were evaluated as diagnostic tools and in follow-up with samples from 63 infected and 37 noninfected persons. Infected individuals received eradication therapy followed by endoscopic follow-up 35 days after the start of treatment. At that time, a second stool specimen was obtained from 55 of these patients. Before eradication, the sensitivity of PCR was 93.7% and that of EIA 88.9%. Specificities were 100 and 94.6%, respectively. Of the 55 follow-up specimens, 41 originated from patients from whom H. pylori had been eradicated. Of these, 21 were still positive by PCR and 13 were positive by EIA, indicating that 1 month may be too short a period for follow-up evaluation of stool specimens by these tests. 相似文献
6.
J. Raymond C. Sauvestre N. Kalach J. D. de Korwin V. Valverde 《European journal of clinical microbiology & infectious diseases》1999,18(3):192-198
A new semiquantitative enzyme immunoassay (Platelia Helicobacter pylori; Sanofi Diagnostics Pasteur, France) was evaluated and compared with two other serological assays (Gap-test IgG; Bio-Rad,
France; and Cobas Core; Roche, Switzerland) for the diagnosis of Helicobacter pylori infection in children. The three tests were compared with the examination of biopsy samples obtained from 160 dyspeptic subjects
(mean age, 9±4.7 years). Discrepant results were studied using an immunoblot technique. The response obtained for the Platelia
assay in children was significantly lower than that obtained in a previously described population of 92 adults (Helicobacter pylori-negative mean ratios, 0.376 vs. 0.504, P<0.000783;Helicobacter pylori-positive mean ratios, 1.95 vs. 2.67, P<0.000003). Thus, the optimal cut-off for children (0.80) was lower than the one recommended for adults (1.10). According
to the Receiver Operating Characteristic (ROC) curve analysis and to the Wilcoxon value, the Platelia and Cobas Core assays
showed the highest discriminatory properties (Wilcoxon value, 0.94 for both) compared with the Gap-test IgG (Wilcoxon value,
0.91). When the newly established cut-off value (0.80) was used, the performance of Platelia was equivalent to that of Cobas
Core (sensitivity: 94.4% for each; respective specificities, 86.8% and 90.6%). The Gap-test IgG had a lower sensitivity (maximum,
79%) and a higher specificity (maximum, 95.3%), but there were difficulties in interpretation because its grey zone encompassed
12% of the sera. In conclusion, the results showed good performance of the Platelia Helicobacter pylori assay and confirmed the merit of a specific cut-off value for use of this test in children. 相似文献
7.
C. Prell S. Osterrieder C. Lottspeich A. Schwarzer H. Rüssmann G. Ossiander S. Koletzko 《Journal of clinical microbiology》2009,47(12):3980-3984
A modified version of a rapid office based one-step monoclonal immunoassay for detection of Helicobacter pylori antigen in stool samples from children was evaluated against biopsy specimen-based methods and compared to a monoclonal enzyme immunoassay using the same antigen. Blinded stool samples from 185 children (0.3 to 18.2 years) were investigated at the time of upper endoscopy prior to anti-H. pylori therapy; 62 children were H. pylori infected and 123 noninfected according to predefined reference standards. Samples obtained 6 to 8 weeks after anti-H. pylori therapy were available from 58 children (3.8 to 17.7 years) and were compared to results of the [13C]urea breath test (14/58 were positive). The rapid stool tests were performed by two independent readers. Of 243 rapid tests performed, 1 (0.4%) was invalid for technical reasons. Equivocal results (very weak line) were reported 16 times by reader 1 and 27 times by reader 2. When equivocal results were considered positive, the two observers agreed on 76 positive and 160 negative results and disagreed on 7 samples (2.9%). The sensitivity was 90.8% for reader 1 and 85.5% for reader 2, and the specificity was 91.0% and 93.4%, respectively. The monoclonal enzyme immunoassay revealed a sensitivity and specificity of 94.7% and 97.6%, respectively. The modified chromatographic immunoassay is a good alternative in settings or situations when the monoclonal enzyme immunoassay or the [13C]urea breath test are not available or feasible. In order to improve sensitivity, very weak lines should be considered positive test results.Several noninvasive methods are available for the diagnosis of H. pylori infection (5, 14). Serological tests are not appropriate, since they cannot distinguish between a present and previous infection and, in addition, they have a low sensitivity in children younger than 12 years of age (6, 13). The [13C]urea breath test (UBT) is the preferred noninvasive diagnostic tool and gives excellent performance for both adults and children, but specificity decreases in very young and mentally disabled children who are not able to cooperate with the test procedure (10, 11, 25). So far, tests for detection of H. pylori antigen in stool samples are the only noninvasive diagnostic tools which do not show an age dependence for the diagnostic accuracy (14, 15). This makes stool tests very attractive, particularly for young children and for epidemiological studies. Several tests have been developed, but validation studies showed differences in performance. An enzyme immunoassay (EIA) based on polyclonal antibodies that was developed by the Meridian Company has been validated in several studies, with controversial results (17, 20, 24). Lack of accuracy is obviously related to intertest variability (19). In contrast, EIA based on monoclonal antibodies showed consistently excellent results, with very high sensitivity and specificity in both children and adults (15, 21). A meta-analysis with head-to-head comparison has judged the monoclonal EIA superior to the polyclonal EIA (8).Recently, we reported on the performance of a one-step monoclonal chromatographic immunoassay for detection of H. pylori antigen in stool samples from symptomatic children compared to the results of a well-established monoclonal EIA using the same antigen, namely, the catalase of H. pylori (22). Evaluation against biopsy specimen-based diagnostic methods showed a moderate sensitivity but a good specificity. After publication of the data, the manufacturer modified the tests. The aim of this study was to evaluate this new version of the rapid office-based one-step stool test in symptomatic children against invasive diagnostic methods and to compare the results with those of the monoclonal EIA. 相似文献
8.
9.
Evaluation of a Monoclonal Antibody-Based Test for Detection of Helicobacter pylori-Specific Antigen in Stool Samples from Mice 下载免费PDF全文
Julia Crone Erin Symonds Fiona Campbell Ross Butler 《Clinical and Vaccine Immunology : CVI》2004,11(4):799-800
A test using monoclonal antibodies for detection of antigen in stool samples was compared with culture and histology for noninfected (n = 25), Helicobacter pylori-infected (n = 25), and Helicobacter felis-infected (n = 6) mice. Sensitivity and specificity were 96%. The monoclonal antibody-based test is therefore a noninvasive technique that is able to diagnose H. pylori infection in mice. 相似文献
10.
Susceptibilities to different antibiotics of Helicobacter pylori strains isolated from patients at the pediatric medical center of Tehran, Iran 总被引:3,自引:0,他引:3 下载免费PDF全文
Antibiotic susceptibility testing of 70 pediatric Helicobacter pylori isolates was performed by using screening agar and disk diffusion methods. Resistance to metronidazole and tinidazole was 72 to 79% and 71 to 81% by modified disk diffusion and 77% and 78% by screening agar, respectively. Susceptibilities to amoxicillin, ampicillin, clarithromycin, tetracycline, erythromycin, and ciprofloxacin were 58, 69, 75, 68, 68, and 65%, respectively. 相似文献
11.
Evaluation of Pyloriset Screen, a Rapid Whole-Blood Diagnostic Test for Helicobacter pylori Infection 总被引:5,自引:0,他引:5 下载免费PDF全文
Aino Oksanen Lea Veijola Pentti Sipponen Knut-Olof Schauman Hilpi Rautelin 《Journal of clinical microbiology》1998,36(4):955-957
Helicobacter pylori infection can be detected by several invasive tests based on gastroscopy and by noninvasive methods such as serologic assays. Noninvasive tests can be used not only in addition to invasive tests but also by themselves to screen for H. pylori infection in patients who are not in urgent need of endoscopy. Lately, rapid qualitative serologic tests have been developed. In the present study, the accuracy of a novel rapid whole-blood test, Pyloriset Screen, detecting immunoglobulin G (IgG) and IgA antibodies against H. pylori was evaluated. A total of 207 consecutive adult outpatients referred for upper endoscopy were enrolled. Gastric biopsy specimens were taken from the antrum and corpus for histologic examination and rapid urease testing. Cultures were available for 113 patients. Serum samples collected from all patients were tested for H. pylori antibodies by two enzyme immunoassays (EIAs) (Pyloriset EIA and an in-house EIA), a rapid latex agglutination test (Pyloriset Dry), and Pyloriset Screen. Patients were considered H. pylori positive if helicobacters were seen on histologic examination (77 patients) or, if in combination with histologically verified (although helicobacter-negative) gastritis, their IgG antibody titers were elevated in the two EIAs (five patients). The Pyloriset Screen test had a sensitivity of 95%, a specificity of 94%, a positive predictive value of 91%, and a negative predictive value of 97%. Among 63 patients under the age of 45 years, the Pyloriset Screen test did not miss a single H. pylori diagnosis, and only 1 patient had a false-positive result. Pyloriset Screen could be used reliably to screen for H. pylori infection. 相似文献
12.
Evaluation of Helicobacter pylori Immunoglobulin G (IgG), IgA,and IgM Serologic Testing Compared to Stool Antigen Testing 下载免费PDF全文
Rosemary C. She Andrew R. Wilson Christine M. Litwin 《Clinical and Vaccine Immunology : CVI》2009,16(8):1253-1255
The utility of Helicobacter pylori serology was evaluated in 4,722 specimens and compared to stool antigen detection. Immunoglobulin M (IgM) sensitivity (6.8%) was unacceptably low. Key performance differences were observed in IgG specificity, IgA sensitivity, and specificity between adults and children that may warrant differentiating optimal serologic cutoff values by age.Helicobacter pylori causes gastrointestinal disease in both children and adults (10). Noninvasive diagnostic tests include the [13C]urea breath test, serology, and stool antigen testing (HpSA). Numerous studies have evaluated these diagnostic tests but have been limited by a small sample size or restriction to either children or adults (3-9, 11-17, 19, 20). The clinical utility of serologic testing in both children and adults has been debated; moreover, it has not been established whether positive cutoff levels need to be adjusted for age (4, 5, 8, 13, 19). Immunoglobulin A (IgA) and IgG serologic tests are possibly less reliable in children than adults, but this has not been definitively established (13). Some investigators have supported the use of IgM as an indicator of active disease (2), while others have found IgM to have little diagnostic utility (7, 18). Because of the conflicting data, we performed a large-scale study on H. pylori serology to analyze its utility and differences in performance in children and adults.Paired results of H. pylori serology (IgG, IgA, and/or IgM) and HpSA from October 1998 to January 2009 were analyzed in tests performed within 2 months of each other. HpSA was performed using the Premier Platinum HpSA Plus enzyme immunoassay according to the manufacturer''s instructions (Meridian Bioscience, Inc., Cincinnati, OH). The cutoff optical density at 450 nm was <0.100 for a negative result and ≥0.100 for a positive result.Serology has been performed with in-house enzyme-linked immunosorbent assay (ELISA) kits used since 1998. The IgG and IgA ELISAs were validated against the Enteric Products Inc. (Stony Brook, NY) ELISA. The IgM ELISA was validated against the MRL (now Focus Diagnostics, Cypress, CA) IgM ELISA. H. pylori antigens (CagA and VacA; Micro Detect, Inc., Tustin, CA) were used to coat microtiter plates at 1.0 μg/ml. Samples were diluted 1:101 for IgG and IgA and 1:51 for IgM and then reacted at room temperature for 30 min. After washing, diluted horseradish peroxidase-conjugated anti-human IgG, IgA, or IgM was reacted for 30 min at room temperature. After washing again, the wells were developed with tetramethylbenzidine for 30 min and the absorbance was measured at 450 nm. The cutoffs (in index values) for IgG and IgA were ≤1.7 for a negative result, 1.8 to 2.2 for an equivocal result, and ≥2.3 for a positive result. For IgM the cutoffs were ≤0.8 for a negative result, 0.9 to 1.1 for an equivocal result, and ≥1.2 for a positive result.Statistical analyses were performed using SAS software, version 9.1 (SAS Institute Inc., Cary, NC). The study was approved by the Institutional Review Board of the University of Utah (no. 7275).For all tests performed over the 11-year period, including nonpaired samples, the positivity rate of HpSA (12.1% [10,440/86,284]) was significantly lower (P < 0.001) than those for H. pylori IgG (35.6% [155,370/413,222]) and IgA (32.7% [60,091/166,997]), and IgM was significantly less often positive (4.3% [5,320/120,135]) than the other three tests (P < 0.001) based on the binomial test.There were 4,722 paired serology and HpSA results for 2,730 women (57.8%) and 1,992 men (42.2%). Eighty-eight percent of these tests were collected within 2 weeks of each other. Using HpSA as the gold standard, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated with 95% confidence intervals for IgG, IgA, and IgM and according to age group: children (≤17 years) and adults (≥18 years) (Table (Table1).1). IgG demonstrated the highest sensitivity (87.6%) and lowest specificity (61.0%) and was significantly more specific in children (82.6%) than adults (46.2%). In children, IgA was significantly more specific than adults (95.8% versus 48.8%) but also less sensitive (29.6% versus 73.8%). Overall, IgM demonstrated low sensitivity (6.8%) but high specificity (95.8%) with no statistical difference between children and adults.
Open in a separate windowaValues in parentheses are 95% confidence intervals.A receiver operating characteristics (ROC) curve was generated for each antibody tested (Fig. (Fig.1).1). The ROC area for IgG (0.802) was higher than those for IgA (0.698) and IgM (0.615) (P < 0.01, χ2 test). The ROC area for IgA for children was higher than for adults (P < 0.001), as was the ROC area for IgG (P < 0.01) (Fig. (Fig.22 and and3).3). Optimal cutoffs were calculated using an iterative method maximizing the product of sensitivity × (1 − specificity) (Table (Table2).2). No statistically significant differences in ROC curves were noted between male and female patients for IgG, IgA, or IgM serologies.Open in a separate windowFIG. 1.ROC curves for H. pylori IgG, IgA, and IgM, using HpSA as the gold standard.Open in a separate windowFIG. 2.ROC curve for H. pylori IgG, comparing data from children (≤17 years) and adults (≥18 years).Open in a separate windowFIG. 3.ROC curve for H. pylori IgA, comparing data from children (≤17 years) and adults (≥18 years).
Open in a separate windowaCutoff values are reported as index values based on analysis of the respective ROC curve with H. pylori stool antigen as the gold standard. Cutoffs do not include an equivocal range.In this study, IgG correlated better with HpSA than IgA or IgM. IgG was also much more specific in children than adults, corroborating the fact that adults are more likely to have been exposed to H. pylori in the past (6, 8, 11). While some investigators have observed IgA to be equal to IgG in performance (11), others have found it to have no additional benefit (5, 13). Here, IgA yielded poor overall sensitivity and specificity, although it performed better for samples from children than those from adults. Since serology may not measure active disease, it is not surprising that IgG and IgA were more frequently positive than HpSA, a more accurate indicator of active disease (15). These data are consistent with the low specificity of IgA and IgG serologies.IgM has been found to have little diagnostic utility for H. pylori infections and is elevated only acutely after infection, whereas H. pylori infections are generally chronic (8, 18). Here we show that IgM has extremely low sensitivity, confirming its lack of clinical utility in either children or adults.It has been debated whether cutoffs for serology should be adjusted for children versus adults (5, 18). Titers to IgA and IgG increase with age in response to exposures to H. pylori (1, 8). Hence, a lower cutoff may be useful in children to account for this (11). In our analysis, a lower cutoff of 0.8 for IgA in children increased the sensitivity from 29.6% to 70.0% with a lesser decrease in specificity. We recommend that laboratories reevaluate serologic titers based on age to determine if separate cutoffs are warranted. Test characteristics may also vary with different kits and patient population characteristics.This study was strengthened by the extremely large sample volume but potentially limited by lack of clinical data, which were unavailable. We could not differentiate samples used to establish diagnosis from those drawn for follow-up testing. HpSA was used as the gold standard as it offers excellent sensitivity and specificity when compared to invasive methods, such as gastric biopsy, culture, and the rapid urease test (14, 20). Because CagA and VacA were the antigens used in the serologic testing, it is possible that serology was unable to detect antibodies against certain CagA-negative strains that do not produce vacuolating cytotoxin.Using HpSA as the gold standard, we found that the performances of IgG and IgA serology tests differ significantly by age. IgG demonstrated the best performance overall. IgM showed little clinical utility, with an unacceptably low sensitivity. Our data support the use of different cutoffs for children and adults. Further clinical correlation is needed to establish the optimal cutoffs for these groups. 相似文献
TABLE 1.
H. pylori IgG, IgA, and IgM serology performance using H. pylori stool antigen as the gold standardaIg and age group (n) | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | Accuracy (%) |
---|---|---|---|---|---|
IgG | |||||
All ages (2,423) | 87.6 (83.0-91.4) | 61.0 (58.8-63.2) | 22.8 (20.4-25.6) | 97.4 (96.4-98.2) | 64.2 (61.4-66.8) |
≤17 yr (930) | 85.6 (75.6-92.6) | 82.6 (79.8-85.2) | 32.0 (25.6-39.0) | 98.4 (97.0-99.2) | 83.0 (80.0-85.8) |
≥18 yr (1,493) | 88.6 (83.0-92.8) | 46.2 (43.4-49.2) | 20.6 (17.8-23.6) | 96.2 (94.4-97.6) | 52.0 (48-56.2) |
IgA | |||||
All ages (1,284) | 63.4 (54.0-72.2) | 67.6 (64.6-70.4) | 17.6 (14.0-21.6) | 94.4 (92.6-96) | 67.2 (63.8-70.4) |
≤17 yr (462) | 29.6 (13.8-50.2) | 95.8 (93.4-97.4) | 30.8 (14.4-51.8) | 95.6 (93.0-97.2) | 91.8 (89.2-94.4) |
≥18 yr (822) | 73.8 (63.4-82.6) | 48.8 (44.8-52.8) | 16.6 (13.2-20.8) | 96.2 (94.4-97.6) | 51.8 (46.4-57.2) |
IgM | |||||
All ages (1,015) | 6.8 (2.6-14.0) | 95.8 (94.2-97.0) | 13.6 (5.2-27.4) | 91.2 (89.2-93.0) | 87.8 (89.2-93.0) |
≤17 yr (650) | 9.0 (2.6-21.6) | 97.0 (95.2-98.2) | 18.2 (5.2-40.2) | 93.6 (91.2-95.4) | 91.0 (88.6-93.2) |
≥18 yr (365) | 4.4 (0.6-15.2) | 93.4 (90.2-96.0) | 9.0 (1.2-29.2) | 87.0 (82.8-90.4) | 82.2 (78-86.2) |
TABLE 2.
Optimal cutoffs and sensitivities and specificities for H. pylori IgG, IgA, and IgM serologiesIg and age group | Optimal cutoffa | Sensitivity (%) | Specificity (%) |
---|---|---|---|
IgG | |||
All ages | 2.94 | 81.2 | 71.8 |
≤17 yr | 2.45 | 80.0 | 85.9 |
≥18 yr | 5.04 | 72.3 | 74.3 |
IgA | |||
All ages | 1.62 | 70.0 | 60.4 |
≤17 yr | 0.81 | 70.0 | 78.7 |
≥18 yr | 2.55 | 60.0 | 60.9 |
IgM | |||
All ages | 0.27 | 67.0 | 49.2 |
≤17 yr | 0.30 | 34.3 | 65.7 |
≥18 yr | 0.27 | 64.4 | 51.6 |
13.
A Strain-Specific Antigen in Japanese Helicobacter pylori Recognized in Sera of Japanese Children 下载免费PDF全文
Masumi Okuda Toshiro Sugiyama Kenichi Fukunaga Masaru Kondou Eikichi Miyashiro Teruko Nakazawa 《Clinical and Vaccine Immunology : CVI》2005,12(11):1280-1284
An enzyme immuno assay (EIA) test based on Japanese strain-derived high-molecular-weight cell-associated proteins (JHM-CAP) was evaluated by comparing with a previously developed EIA test based on a U.S. strain-derived high-molecular-weight cell-associated proteins (HM-CAP). Serum samples of 131 Japanese asymptomatic children (mean age, 5.5 years; range, 0 to 21 years) were tested that include 43 positive and 88 negative children as judged by Helicobacter pylori stool antigen test (HpSA test). Both tests showed comparable and reliable specificities, but the sensitivity of JHM-CAP EIA, at 93.0%, was much higher than that of HM-CAP EIA, at 67.4%. More false-negative results of HM-CAP were obtained in children under 10 years of age. Immunoblot analysis revealed that the JHM-CAP but not the HM-CAP preparation had a 100-kDa antigen recognized by JHM-CAP positive sera. It was concluded that JHM-CAP EIA is highly accurate for the serodiagnosis of H. pylori infection in Japanese young children and that the high sensitivity of JHM-CAP EIA in contrast to HM-CAP EIA is due to the presence of a 100-kDa antigen in Japanese strains that may be recognized by the host immune system at an early stage of infection. 相似文献
14.
目的研究儿童上消化道出血与幽门螺杆菌(Helicobacter pylori,Hp)感染之间的关系。方法对98例上消化道出血患儿组和65例非上消化道出血患儿组同时用13C-尿素呼气试验(13C-UBT)和采用ELISA法测定血清Hp抗体来判断Hp感染情况,所有患儿均行电子胃镜检查。结果上消化道出血患儿组和非上消化道出血患儿组的Hp阳性率分别为59.18%、18.46%,两组比较差异有统计学意义(P〈0.001)。结论儿童上消化道出血与幽门螺杆菌感染有密切关系。 相似文献
15.
Diagnosis of Helicobacter pylori Infection in Children: Comparison of a Salivary Immunoglobulin G Antibody Test with the [13C]Urea Breath Test 下载免费PDF全文
G. Bode P. Marchildon J. Peacock H. Brenner D. Rothenbacher 《Clinical and Vaccine Immunology : CVI》2002,9(2):493-495
The prevalence of Helicobacter pylori infection in a population-based sample of 477 children (mean age ± standard deviation, 5.8 ± 0.5 years) determined by the [13C]urea breath test ([13C]UBT) was 10.7% (95% confidence interval [CI], 8.1 to 13.8%), and that determined by salivary enzyme-linked immunosorbent assay (ELISA) was 11.9% (95% CI, 9.2 to 15.2%). Compared to the [13C]UBT, the sensitivity and specificity of the salivary ELISA were 80.9% (95% CI, 66.3 to 90.4%) and 95.3% (95% CI, 92.7 to 97.1%), respectively. 相似文献
16.
Use of a Gastric Juice-Based PCR Assay To Detect Helicobacter pylori Infection in Culture-Negative Patients 总被引:2,自引:0,他引:2 下载免费PDF全文
Haruhiko Yoshida Katsutaro Hirota Yasushi Shiratori Takeshi Nihei Shin Amano Akira Yoshida Osamu Kawamata Masao Omata 《Journal of clinical microbiology》1998,36(1):317-320
A gastric juice-based PCR assay was compared with culture, microscopy, and a rapid urease test with specimens from 114 subjects. The PCR and conventional tests were positive for 76 and 62% of the subjects, respectively. The prevalence of gastroduodenal disease and seropositivity for anti-Helicobacter pylori immunoglobulin G were similarly high among conventional-test-positive and PCR-only-positive subjects compared to all-negative ones. The PCR assay is recommended to confirm the H. pylori status of culture-negative peptic-ulcer patients. 相似文献
17.
Production and Application of New Monoclonal Antibodies Specific for a Fecal Helicobacter pylori Antigen 下载免费PDF全文
Nobuyuki Suzuki Masahiko Wakasugi Seigo Nakaya Keiko Okada Ritsuko Mochida Masami Sato Hirofumi Kajiyama Ryoki Takahashi Haruhisa Hirata Yohji Ezure Yasuhiro Koga Yoshihiro Fukuda Takashi Shimoyama 《Clinical and Vaccine Immunology : CVI》2002,9(1):75-78
The aim of the present study was to establish monoclonal antibodies that could be used to produce a diagnostic test composed of one kind of monoclonal antibody recognizing a fecal Helicobacter pylori antigen. The need to develop such a test arose from disadvantages of the diagnostic test that uses a polyclonal antibody or plural kinds of monoclonal antibodies, such as the lower specificity for H. pylori antigen and the difficulty of reproduction with consistent quality. Mice were immunized with sonicated cells of the coccoid form of H. pylori, and fecal samples from H. pylori-positive subjects were screened by a direct sandwich enzyme immunoassay (EIA) for antibody production from 32 hybridoma clones. The three stable clones produced antibodies (21G2, 41A5, and 82B9) that reacted with the same soluble antigen. Gel filtration chromatography showed that the molecular masses of the cellular antigen and the fecal antigen were the same, 260 kDa. The antigen was labile in response to sodium dodecyl sulfate and heat treatments. A single-step direct sandwich EIA using a single monoclonal antibody, 21G2, was developed. The EIA could detect the antigen in 41 H. pylori clinical isolates and in fecal samples from seven H. pylori-positive subjects. Several kinds of Helicobacter species (Helicobacter felis, Helicobacter hepaticus, Helicobacter mustelae, and Helicobacter cinaedi) except H. pylori, major bacteria in feces (Campylobacter jejuni, Bacteroides vulgatus, Bifidobacterium breve, Bifidobacterium infantis, and Escherichia coli), and fecal samples from six H. pylori-negative subjects showed negative results. These results indicate that the new monoclonal antibodies and the new specific EIA would be useful as a noninvasive method of diagnosis of H. pylori infection. 相似文献
18.
The effect of low-dose antigen exposure on the development of immunity to Helicobacter pylori infection was studied in outbred mice. Animals that were primed with a subinfectious number of H. pylori bacteria exhibited significantly lower bacterial loads after challenge with an infectious dose of pathogen (versus controls, P < 0.05). 相似文献
19.
Gyu Young Pih Jin Hee Noh Ji Yong Ahn Gill Sang Han Hyun Suk Jung Hwoon-Yong Jung Jung Mogg Kim 《Journal of Korean medical science》2022,37(29)
BackgroundThe rapid urease test (RUT) is a major diagnostic tool for detecting Helicobacter pylori infection. This study aimed to establish an objective method for measuring the color changes in the RUT kit to improve the test’s diagnostic accuracy.MethodsA UV-visible spectrophotometer was selected as the colorimeter; experiments were conducted in three stages to objectively identify the color changes in the RUT kit.ResultsFirst, the urea broth solution showed an identifiable color change from yellow to red as the pH increased by 0.2. The largest transmittance difference detected using the UV-visible spectrophotometer was observed at a 590-nm wavelength. Second, the commercialized RUT kit also showed a gradual color change according to the pH change detected using the UV-visible spectrophotometer. Third, 13 cases of negative RUT results with a biopsy specimen and 16 of positive RUT results were collected. The transmittance detected using the UV-visible spectrophotometer showed a clear division between the positive and negative RUT groups; the largest difference was observed at a 559-nm wavelength. The lowest transmittance in the negative RUT group was 64, while the highest in the positive RUT group was 56, at the 559-nm wavelength. The UV-visible spectrophotometry reading showed a consistency of 92.7% compared with that of manual reading.ConclusionA transmittance of 60 at a 559-nm wavelength detected using UV-visible spectrophotometer can be used as a cutoff value for interpreting RUT results; this will help develop an automatic RUT kit reader with a high accuracy. 相似文献
20.
Elitza S. Theel Ryan D. Johnson Elizabeth Plumhoff Curtis A. Hanson 《Journal of clinical microbiology》2015,53(4):1358-1360
We surveyed national Helicobacter pylori diagnostic testing practices and diagnoses using commercial and Medicare medical claims data from Optum Labs (Cambridge, MA). Serologic testing for antibodies to H. pylori remains the most commonly ordered diagnostic test despite recent expert recommendations. Changes in reimbursement for serologic testing will likely drive future provider ordering practices. 相似文献