Helicobacter pylori infection in infants and toddlers in south america: Concordance between [13c]urea breath test and monoclonal h. Pylori stool antigen test

Dulciene Maria Magalhães Queiroz, Mayuko Saito, Gifone Aguiar Rocha, Andreia Maria Camargos Rocha, Fabrício Freire Melo, William Checkley, Lúcia Libanez Bessa C. Braga, Igor Simões Silva, Robert H. Gilman, Jean E. Crabtree

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)3735-3740
Number of pages6
JournalJournal of clinical microbiology
Volume51
Issue number11
DOIs
StatePublished - Nov 2013

ASJC Scopus subject areas

  • Microbiology (medical)

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