Non-invasive diagnosis of infection in adult dyspeptic patients by stool antigen detection: does the rapid immunochromatography test provide a reliable alternative to conventional ELISA kits? Free

Abstract

Stool antigen-testing allows non-invasive detection of that is indicative of active infection. Three commercial kits are currently marketed in the UK for stool antigen-testing. The aim of this study was to conduct a comparative evaluation of the performances of each of these tests, compared with culture and histological examination of gastric biopsies, for pre-treatment diagnosis of infection in an adult dyspeptic population in south-east England. Examination of 112 stool samples by the Premier Platinum HpSA ELISA (Meridian Diagnostics) and by the Amplified IDEIA HpStAR ELISA (DakoCytomation) kits demonstrated that the latter was more sensitive (81.3 versus 93.8 %, respectively) and specific (91.7 versus 100.0 %, respectively). Additionally, the IDEIA HpStAR was easier to interpret, with OD readings of positive and negative results being far from the recommended cut-off, whereas equivocal results that were generated by the HpSA kit were difficult to interpret. Additional testing of 87 of the 112 stools by the ImmunoCard STAT! HpSA kit (Meridian Diagnostics) demonstrated that this test was easier to perform than ELISA and was more sensitive than the HpSA kit but, compared with the IDEIA HpStAR kit, the ImmunoCard test was less sensitive (87.8 versus 95.9 %, respectively) and specific (89.4 versus 100.0 %, respectively). Furthermore, the ImmunoCard test generated weakly positive results, correlating with lower OD readings for both ELISA kits, that were difficult to interpret. The Amplified IDEIA HpStAR kit is therefore the most sensitive and specific of the three tests that are available for pre-treatment, non-invasive detection of in stool samples in an English adult dyspeptic population.

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2004-07-01
2024-03-29
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References

  1. Casswall T. H., Nilsson H.-O., Bergström M., Aleljung P., Wadström T., Dahlström A. K., Albert M. J., Sarker S. A. 1999; Evaluation of serology, 13C-urea breath test, and polymerase chain reaction of stool samples to detect Helicobacter pylori in Bangladeshi children. J Pediatr Gastroenterol Nutr 28:31–36 [CrossRef]
    [Google Scholar]
  2. Garcia L. S., Shimizu R. Y., Novak S., Carroll M., Chan F. 2003; Commercial assay for detection of Giardia lamblia and Cryptosporidium parvum antigens in human fecal specimens by rapid solid-phase qualitative immunochromatography. J Clin Microbiol 41:209–212 [CrossRef]
    [Google Scholar]
  3. Gisbert J. P., Pajares J. M. 2001; Diagnosis of Helicobacter pylori infection by stool antigen determination: a systematic review. Am J Gastroenterol 96:2829–2838 [CrossRef]
    [Google Scholar]
  4. Helicobacter and Cancer Collaborative Group; 2001; Gastric cancer and Helicobacter pylori : a combined analysis of 12 case control studies nested within prospective cohorts. Gut 49:347–353 [CrossRef]
    [Google Scholar]
  5. Koletzko S., Konstantopoulos N., Bosman D., Feydt-Schmidt A., van der Ende A., Kalach N., Raymond J., Rüssmann H. 2003; Evaluation of a novel monoclonal enzyme immunoassay for detection of Helicobacter pylori antigen in stool from children. Gut 52:804–806 [CrossRef]
    [Google Scholar]
  6. Konstantopoulos N., Rüssmann H., Tasch C., Sauerwald T., Demmelmair H., Autenrieth I., Koletzko S. 2001; Evaluation of the Helicobacter pylori stool antigen test (HpSA) for detection of Helicobacter pylori infection in children. Am J Gastroenterol 96:677–683 [CrossRef]
    [Google Scholar]
  7. Leodolter A., Peitz U., Ebert M. P., Agha-Amiri K., Malfertheiner P. 2002; Comparison of two enzyme immunoassays for the assessment of Helicobacter pylori status in stool specimens after eradication therapy. Am J Gastroenterol 97:1682–1686 [CrossRef]
    [Google Scholar]
  8. Mackenzie A., Orrbine E., Hyde L. 7 other authors; 2000; Performance of the ImmunoCard STAT! E.coli O157 : H7 test for detection of Escherichia coli O157 : H7 in stools. J Clin Microbiol 38:1866–1868
    [Google Scholar]
  9. Makristathis A., Barousch W., Pasching E., Binder C., Kuderna C., Apfalter P., Rotter M. L., Hirschl A. M. 2000; Two enzyme immunoassays and PCR for detection of Helicobacter pylori in stool specimens from pediatric patients before and after eradication therapy. J Clin Microbiol 38:
    [Google Scholar]
  10. NIH Consensus Conference 1994; Helicobacter pylori in peptic ulcer disease.NIH Consensus Development Panel on Helicobacter pylori in Peptic Ulcer Disease. JAMA 272:65–69 [CrossRef]
    [Google Scholar]
  11. Odaka T., Yamaguchi T., Koyama H., Saisho H., Nomura F. 2002; Evaluation of the Helicobacter pylori stool antigen test for monitoring eradication therapy. Am J Gastroenterol 97:594–599 [CrossRef]
    [Google Scholar]
  12. Oderda G., Rapa A., Ronchi B., Lerro P., Pastore M., Staiano A., de'Angelis G. L., Strisciuglio P. 2000; Detection of Helicobacter pylori in stool specimens by non-invasive antigen enzyme immunoassay in children: multicentre Italian study. BMJ 320:347–348 [CrossRef]
    [Google Scholar]
  13. Shepherd A. J., Williams C. L., Doherty C. P., Hossack M., Preston T., McColl K. E. L., Weaver L. T. 2000; Comparison of an enzyme immunoassay for the detection of Helicobacter pylori antigens in the faeces with the urea breath test. Arch Dis Child 83:268–270 [CrossRef]
    [Google Scholar]
  14. Vaira D., Menegatti M., Ricci C., Gatta L., Berardi S., Miglioli M. 2000; Accurate diagnosis of Helicobacter pylori .Stool tests. Gastroenterol Clin North Am 29:917–923 [CrossRef]
    [Google Scholar]
  15. Vaira D., Vakil N., Menegatti M. & 13 other authors; 2002; The stool antigen test for detection of Helicobacter pylori after eradication therapy. Ann Intern Med 136:280–287 [CrossRef]
    [Google Scholar]
  16. Vyse A. J., Gay N. J., Hesketh L. M., Andrews N. J., Marshall B., Thomas H. I., Morgan-Capner P., Miller E. 2002; The burden of Helicobacter pylori infection in England and Wales. Epidemiol Infect 128:411–417
    [Google Scholar]
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