Diagnosis Of Helicobacter Pylori Research Articles

A Prototype of Graphene E-Nose for Exhaled Breath Detection and Label-Free Diagnosis of Helicobacter Pylori Infection.

Helicobacter pylori (HP), a common microanaerobic bacteria that lives in the human mouth and stomach, is reported to infect ≈50% of the global population. The current diagnostic methods for HP are either invasive, time-consuming, or harmful. Therefore, a noninvasive and label-free HP diagnostic method needs to be developed urgently. Herein, reduced graphene oxide (rGO) is composited with different metal-based materials to construct a graphene-based electronic nose (e-nose), which exhibits excellent sensitivity and cross-reactive response to several gases in exhaled breath (EB). Principal component analysis (PCA) shows that four typical types of gases in EB can be well discriminated. Additionally, the potential of the e-nose in label-free detection of HP infection is demonstrated through the measurement and analysis of EB samples. Furthermore, a prototype of an e-nose device is designed and constructed for automatic EB detection and HP diagnosis. The accuracy of the prototype machine integrated with the graphene-based e-nose can reach 92% and 91% in the training and validation sets, respectively. These results demonstrate that the highly sensitive graphene-based e-nose has great potential for the label-free diagnosis of HP and may become a novel tool for non-invasive disease screening and diagnosis.

Diagnosis Study of Peptic Ulcer in Iraqi Patients Students

Background: Even in the absence of a Helicobacter pylori infection, psychological stress and a need for fast food can cause peptic ulcer. Research on the relationship between sociodemographic traits and peptic ulcers has revealed a number of risk factors, including a packed family, poor income, unemployment, marital tension, and physical and mental strain. The aim of the current study is to determine the clinical picture of gastric ulcer based on medical history and social status in a sample of Iraqi patients. Methods: Students studying science and medicine who had signs of peptic ulcer disease were the subjects of a cross-sectional investigation. The sample was collected during the period of one year, November 2021 to February 2022. Initially, the procedure was elucidated to the patients, and informed consent was obtained from all enrolled individuals. Peptic ulcer disease was diagnosed by routine examinations, Helicobacter pylori diagnosis by stool antigen test, and gastroduodenoscopy of the patients, in addition to taking the medical history and information about the social status. Results: The study included 45 patients with peptic ulcer, 15 (33.33%) males and 30 (66.66%) females, aged 19-26 years. The control group was 25 healthy individuals, and their symptoms were either acute abdominal pain proven to be caused by peptic ulcer in the patients or hematemesis in 13 (28.88%) patients. Conclusion: Peptic ulcers can be visualised and bleeding can occur, so there should be awareness of pain management and prompt treatment. There should be good and effective analgesia, reassurance, and empathy with patients, and advice on protection against gastric and intestinal ulcers when needed.

Association of gastroesophageal reflux disease with gastritis activity in schoolchildren living in a region with a high incidence of gastric and esophageal cancer

Aim. To study the activity of the inflammatory process in the gastric mucosa (GM) in gastroesophageal reflux disease (GERD) in schoolchildren living in a region with a high incidence of stomach and esophageal cancer. Material and methods. The transverse method in the Republic of Tyva collected data on the presence of gastroenterological complaints in 1535 schoolchildren aged 7-17 years. The main diagnostic criterion for GERD was the presence of weekly heartburn in the subjects. Subsequently, esophagogastroduodenoscopy was performed with the taking of biopsy material of the mucosa of the antrum and body of the stomach in 246 children. Morphological assessment of GM was carried out in accordance with the Sydney classification after staining biopsy sections with hematoxylin-eosin. Diagnosis of Helicobacter pylori was carried out after staining according to Giemsa. The studies were approved by the ethics committee and the consent of the examined was obtained. Results. Schoolchildren in Tyva have a high prevalence of GERD (9.5%). Associative relationship of GERD with gastritis activity, both in the body (p=0.7338) and in the antrum (p=0.2036) was not revealed. In the antrum, the activity of gastritis was higher than in the body of the stomach (p=0.0001). In children with GERD, when infected with Helicobacter pylori, there was an increase in activity, both in the antrum (p=0.0001) and in the body of the stomach (p=0.0159). At the same time, in children with GERD, the inflammatory process is associated with infection by a microorganism, regardless of its belonging to the Cag A strain. Conclusion. An association of GERD with highly active Helicobacter pylori associated gastritis has been established, regardless of whether the microorganism belongs to the Cag A strain.

Accuracy of gastric nodule combined with rapid urease test prediction in diagnosing Helicobacter pylori infection in children.

The diagnosis of Helicobacter pylori (H. pylori) infection in children remains challenging with the lack of a rapid, cost-effective, and highly accurate diagnostic method. Consequently, this study aimed to investigate the accuracy of the combination of gastric nodule and rapid urease test (RUT) as a diagnostic method for H. pylori infection in children. The study included participants who underwent a thorough examination, including gastroscopy, a 13C breath test, RUT, and pathological methylene blue staining, with the gold standard for diagnosing of H. pylori infection being a positive result from both pathological methylene blue staining and 13C breath test. The sensitivity, specificity, positive and negative predictive values, and accuracy of the diagnostic methods were calculated. The accuracy of the different tests for H. pylori infection was evaluated in 2202 participants. A total of 730 (33.2%) children were diagnosed with H. pylori infection (pathological methylene blue staining and 13C breath test, both positive). Gastric nodule had a sensitivity of 87.1% and a specificity of 93.1%, whereas combining gastric nodule and RUT in parallel had the higher accuracy of 95.4%. The accuracy of gastric nodule diagnosis was higher in younger age groups and increased after excluding patients with a history of anti-H. pylori treatment. The findings of this study suggest that gastric nodules, particularly when combined with RUT, can be a valuable predictor of H. pylori infection in children, offering a simple and feasible alternative to other invasive methods.

Knowledge and approach towards Helicobacter pylori diagnosis and management among primary care physicians in Cameroon: a cross-sectional study.

Low- and middle-income countries have a high prevalence of Helicobacter pylori infection (HPI). In Cameroon, the majority of HPIs are diagnosed and treated by primary care physicians (PCPs). We sought to assess the knowledge and practices of PCPs in the diagnosis and management of HPI in Cameroon. A hospital-based cross-sectional study was carried out in four randomly selected regions of Cameroon from November 2021 to June 2022. In each of the selected regions, PCPs were recruited by non-probability convenience sampling and interviewed using a pre-structured questionnaire. Chi-squared, Fisher's exact and Student's t-tests were performed for descriptive analyses. Multivariable logistic regression was used to examine associations between knowledge and practice, with the model adjusted by age of the PCP, geographic region, number of patients and years in practice. Analysis was performed in SAS version 9.4 (SAS Institute, Cary, NC, USA). A total of 382 PCPs were included in the analysis. The majority (60.0%) were males between the ages of 20-29y (64.1%). Most PCPs (80.9%) reported that HPI is the cause of gastroesophageal reflux disease and 41.8% reported that HPI is the main cause of dyspeptic symptoms. The dominant diagnostic tests used for HPI were serology (52.8%) and stool antigen (30.9%). The most frequently used first-line therapies were amoxicillin (AMX), clarithromycin (CLA), metronidazole (MNZ) and proton pump inhibitor (PPI) concomitant therapy (32.2%), AMX-CLA-PPI triple therapy (18.6%) and AMX-MNZ-PPI triple therapy (13.1%). Half of the practitioners (48.6%) treat HPI empirically, without positive H. pylori testing. About half of the PCPs (48%) do not request laboratory confirmation of H. pylori eradication following treatment. There is inadequate knowledge and significant differences in the clinical approach towards HPI among PCPs in Cameroon. We recommend more teaching programs and continuous medical education on HPI.

Healthcare costs among patients with newly diagnosed helicobacter pylori infection in the United States: a linked claims-EHR study

AimsThe study objectives were to 1) characterize the cost drivers of patients with Helicobacter pylori (HP) and 2) estimate HP-related cost savings following lab-confirmed HP eradication with US guideline-recommended treatment compared to failed eradication.MethodsWe identified adults newly diagnosed with HP between 1/1/2016–12/31/2019 in the Veradigm Electronic Health Record Database linked to claims data (earliest HP diagnosis = index date). For the overall costs analysis, we required patients to have data available for ≥12 months before and after the index date. Then, we used multivariable modeling to assess the marginal effects of comorbidities on all cause-healthcare costs in the 12 months following HP diagnosis. For the eradication savings analysis, we identified patients with ≥1 HP eradication regimen, a subsequent HP lab test result, and ≥1 year of data after the test result. Then we used multivariable modeling to estimate HP-related cost while adjusting for eradication status, demographics, post-testing HP-related clinical variables, and the interactions between eradication status and each HP-related clinical variable.ResultsThe overall cost analysis included 60,593 patients with HP (mean age 54.2 years, 65.5% female). Mean (SD) 12-month unadjusted all-cause costs were $23,693 ($78,089). Rare comorbidities demonstrated the highest marginal effect. The marginal effects of gastric cancer and PUD were $15,705 and $7,323, respectively. In the eradication savings analysis, 1,835 (80.0%) of the 2295 patients had lab test-confirmed HP eradication. Compared to failed eradication, there were significant one-year cost savings among patients with successful HP eradication and select conditions: $1,770 for PUD, $518 for atrophic gastritis, $494 for functional dyspepsia, and $352 for gastritis.ConclusionsThe healthcare costs of patients with HP are partially confounded by their burden of high-cost comorbidities. In the subset of patients with available results, confirmed vs. failed eradication of HP was associated with short-term cost offsets among those with specific to HP-related sequelae.

Insights into the Pathogenesis, Virulence Factors, and Diagnosis of Helicobacter pylori: A Comprehensive Review

The H. pylori bacterium, which resides in the human stomach and is linked to a number of gastrointestinal illnesses, is introduced in-depth in this article. We examine how H. pylori establishes infection, thwarts the hosting immune response, and causes inflammation as we explore the pathophysiology of this bacterium. We also talked about how H. pylori influences host cells and develops a favorable environment for survival. We also go over the many methods for identifying H. pylori, such as endoscopy, biopsy, blood, breath, feces, and others. We stress the importance of an accurate and speedy diagnosis while outlining the advantages and disadvantages of each diagnostic strategy to manage disorders caused by H. pylori effectively. Throughout this review, we aim to unravel the mysteries surrounding H. pylori, providing valuable insights into its pathogenesis, the intricate interplay of virulence factors, and the diverse diagnostic strategies employed in clinical practice. Enhancing our understanding of H. pylori can pave the way for improved therapies and patient outcomes.

A Comparison Between Histology and Rapid Urease Test in the Diagnosis of Helicobacter Pylori in Gastric Biopsies: A Systematic Review.

Helicobacter pylori (H. pylori)is a gram-negative aerobic pathogen that primarily colonizes the gastric mucosa. Peptic ulcer disease, atrophic gastritis, gastric cancer, and mucosal-associated lymphoid tissuelymphoma have all been linked to chronic H. pyloriinfection. Hence, it is critical to diagnose and treat it as early as possible. There are both invasive and noninvasive tests available to detect it. In this review, the diagnostic abilities of two invasive tests - histology and the rapid urease test (RUT) - are compared in a variety of clinical situations. This systematic review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 checklist. We performed a literature search using the PubMed and Google Scholar databases in accordance with the eligibility criteria and ultimately selected eight articles for final analysis. The Newcastle-Ottawa scale adapted for cross-sectional studies, the Scale for the Assessment of Narrative Review Articles (SANRA), and the PRISMA 2020 checklist were used to assess the quality of selected articles for cross-sectional studies, traditional literature reviews, and systematic reviews, respectively. According to the findings of the review, both histology and the RUT have highsensitivity and specificity in diagnosing H. pylori thoughthis varies depending on the clinical situation, making one test superior to the other. Neither of these tests can be considered the gold standard method on its own. Hence, using at least two diagnostic tests at the same time is critical for ensuring high sensitivity and specificity while accurately diagnosing the pathogen.

Association of gastroesophageal reflux disease with gastritis activity in schoolchildren living in a region with a high incidence of gastric and esophageal cancer

Aim. To study the activity of the inflammatory process in the gastric mucosa (GM) in gastroesophageal reflux disease (GERD) in schoolchildren living in a region with a high incidence of stomach and esophageal cancer. Material and methods. The transverse method in the Republic of Tyva collected data on the presence of gastroenterological complaints in 1535 schoolchildren aged 7-17 years. The main diagnostic criterion for GERD was the presence of weekly heartburn in the subjects. Subsequently, esophagogastroduodenoscopy was performed with the taking of biopsy material of the mucosa of the antrum and body of the stomach in 246 children. Morphological assessment of GM was carried out in accordance with the Sydney classification after staining biopsy sections with hematoxylin-eosin. Diagnosis of Helicobacter pylori was carried out after staining according to Giemsa. The studies were approved by the ethics committee and the consent of the examined was obtained. Results. Schoolchildren in Tyva have a high prevalence of GERD (9.5%). Associative relationship of GERD with gastritis activity, both in the body (p=0.7338) and in the antrum (p=0.2036) was not revealed. In the antrum, the activity of gastritis was higher than in the body of the stomach (p=0.0001). In children with GERD, when infected with Helicobacter pylori, there was an increase in activity, both in the antrum (p=0.0001) and in the body of the stomach (p=0.0159). At the same time, in children with GERD, the inflammatory process is associated with infection by a microorganism, regardless of its belonging to the Cag A strain. Conclusion. An association of GERD with highly active Helicobacter pylori associated gastritis has been established, regardless of whether the microorganism belongs to the Cag A strain.

Evaluation of a Specific Modulation Frequency Technique for Detecting H. pylori in a Model of Experimentally Infected Mice.

Diagnosis of Helicobacter pylori is challenging. Diverse techniques have been developed for accurate diagnosis. However, they have some limitations. This research investigated the efficacy of specific modulation frequency (SMF) compared to other routine diagnostic methods for detecting H. pylori in gastric biopsy samples of experimentally infected mice. One-hundred and fifty healthy male C57BL/6 mice were included and divided into the control and treatment groups. The mice in the treatment group were treated with 0.2 ml of 0.2 M NaHCO3 to neutralize gastric acidity. Then, 109 colony-forming units of H. pylori (ATCC 43504) mixed in PBS were used intragastrically to inoculate the mice. Mice were kept for up to 28 days and examined on days 0, 7, 14, 21, and 28 using culture, polymerase chain reaction (PCR), and SMF. On day 0, only the SMF and PCR could detect the H. pylori in the stomach of 60% and 20% of mice, respectively. On day 7, culture, PCR, and SMF could detect H. pylori in 40%, 80%, and 100% of mice, respectively. SMF detected all infected mice from days 7 to 28 (100%). PCR detected all H. pylori-infected mice at days 14 to 27 (100%). Another test (culture) detected all infected mice only on day 28. Significant differences were found among the three diagnostic methods on days 0, 7, 14, and 21 of the experiment (P<0.05). SMF was found to have high sensitivity and specificity for H. pylori detection in the early stages of infection.

S1621 Evaluating Knowledge and Approach Towards Helicobacter pylori Diagnosis and Management Among Primary Care Physicians in Cameroon, West Africa

Introduction: Low-middle income countries have high Helicobacter pylori prevalence, with acquisition mostly in early childhood. Recent studies from Africa show especially high rates of resistance to first-line antibiotics used to treat H. pylori. We sought to assess the knowledge and practices of primary care physicians (PCPs) in the diagnosis and management of H. pylori infection in Cameroon. Methods: A hospital-based cross-sectional study was conducted in 4 randomly selected regions of Cameroon, from November 2021 to June 2022. PCPs were recruited by non-probability convenience sampling and interviewed by pre-structured questionnaire on knowledge and approach to H. pylori diagnosis and management. Chi-square, Fisher exact, and Student’s t-tests were performed for descriptive analyses. Multivariable logistic regression was used to examine associations between knowledge and practice, with the model adjusted by PCP age, geographic region, number of patients, and years in practice. Analysis was performed in SAS version 9.4. Results: A total of 382 PCPs were included (Table). Most (60%) were males, between the ages of 26 – 30 years (60%). The majority had been 2 – 6 years in practice (57%), saw < 10 patients per day (54%), and had not attended postgraduate training on H. pylori (87%). About 80% of PCPs considered H. pylori the cause of GERD symptoms, and about 42% thought H. pylori the main cause of dyspepsia (Figure). The dominant diagnostic tests used were serology (53%) and stool antigen (31%). The most prescribed antibiotics for H. pylori eradication were Amoxicillin (AMX, 83%), Clarithromycin (CLA, 74%), and Metronidazole (MNZ, 65%). The most frequently used first-line therapies were AMX/CLA/MNZ & PPI concomitant (40%), AMX/CLA/PPI triple (22%), and AMX/MNZ/PPI triple (15%). Forty-eight percent of PCPs stated they treated H. pylori infection without a confirmed diagnosis; 38% reported not treating asymptomatic cases with a positive H. pylori test or referring such cases to a gastroenterologist; 52% request laboratory confirmation of H. pylori eradication, with the majority (58%) using serology. If first-line therapy fails, 54% of PCPs then refer to gastroenterologists. Large gaps exist between PCP perception of guidelines versus actual practice for H. pylori diagnostic tests: serology (75%), stool antigen (83%), or urea breath (87%). Conclusion: The majority of PCPS lack the knowledge for adequate diagnosis and management of H. pylori. Strategies targeting PCP education are needed to improve the management of H. pylori infection in Cameroon.Figure 1.: Knowledge (Panel A) and approach (Panel B) of Primary Care Providers (PCPs) regarding diagnosis of H. pylori infection in Cameroon, 2022. Table 1. - Population characteristics of primary care physicians in Cameroon, 2022 Age n (%) 21 – 25 years old 64 (17.5) 26 – 30 years old 218 (59.7) 30 – 59 years old 83 (22.7) Gender Female 148 (38.7) Male 229 (60.0) Prefer not to say 5 (1.3) School of Training FHS Bamenda 67 (17.5) FHS Buea 99 (25.9) FMBS Yaoundé 23 (6.0) FMPS Douala 81 (21.2) ISS UDM Bangante 31 (8.1) ISTM Nkolondom 13 (3.4) Trained abroad 68 (17.8) Region of Practice Littoral 144 (37.7) Northwest 74 (19.4) Southwest 95 (24.9) West 69 (18.1) Years in Practice Less than 2 years 122 (33.4) 2 - 6 years 210 (57.3) 6 or more years 33 (9.0) Number of patients per day ≤ 10 197 (54.12) 10 - 19 128 (35.2) ≥ 20 39 (10.7) Attended postgraduate training and/or conferences on H. pylori No/Unsure 330 (86.8) Yes 50 (13.2)

Evaluation of the Diagnostic Value of FliD, a Helicobacter pylori Flagellar Protein.

Novel immunodominant antigens are urgently required for the diagnosis and vaccination of Helicobacter pylori (HP). FliD, an important colonization factor, was cloned and expressed (rFliD) to evaluate the levels of specific immunoglobulin G (IgG), IgM, and IgA antibodies in the serum of patients using ELISA. Rabbit anti-rFliD polyclonal antibody (pAb) was obtained by the subcutaneous injection of rFliD. The rFliD-specific IFN-γ and IL-4 levels in peripheral blood mononuclear cells and CD4+ T cells from humans were analyzed using enzyme-linked immunospot and flow cytometry. We found that the levels of rFliD-specific IgG, IgM, and IgA were significantly higher in HP-infected-patients than in healthy controls. IgG, IgM, and IgA had diagnostic sensitivities of 92.6%, 89.8%, and 83.2%; specificities of 91.1%, 88.7%, and 64.6%; and areas under the receiver operating curves of 0.97, 0.96, and 0.92, respectively. Furthermore, rFliD-pAb was used for the immunohistochemical analysis of gastritis and gastric cancer tissues from patients infected with HP. The levels of rFliD-specific IFN-γ and IL-4 were significantly elevated in HP-infected patients and exhibited a dominant T helper type 1-dominant subtype. These findings indicate that rFliD exhibits high validity as a biomarker in HP diagnosis and may also be a potent antigen for vaccine design because of its high cellular and humoral immune responses.

Antibiotics Resistance Prevalence of Helicobacter pylori Strains in Northwest China.

PurposeThis study aims to estimate the resistance rate of Helicobacter pylori (HP) to commonly used antibiotics and analyze the potential influencing factors in northwest regions of China.Patients and MethodsHP-positive patients visiting the outpatient department of multiple hospitals were enrolled in the study. Then, gastric mucosal biopsy specimens were collected for HP isolation, culture, and investigation of the resistance rate of HP to amoxicillin, metronidazole, tetracycline, levofloxacin, and clarithromycin by Epsilometer test (E-test) antibiotic susceptibility testing. In addition, multi-drug resistance, the influence of HP eradication history, age, and region of residence on drug resistance rate were analyzed.ResultsIn total, 198 HP clinical strains were successfully isolated and cultured. The resistance rates of amoxicillin, metronidazole, tetracycline, levofloxacin, and clarithromycin were 16.16%, 85.86%, 7.58%, 46.46%, and 55.05%, respectively. The multi-drug resistance rates demonstrated that dual and triple resistances were 30.30% and 22.73%, respectively. The quadruple resistance rate reached 9.60%. Our results revealed that the prior eradication history of HP significantly increased levofloxacin and clarithromycin resistance. Metronidazole and levofloxacin resistances significantly differed among different age groups, which presented an upward trend with increasing age. Drug resistance rates varied with geographic regions, especially amoxicillin and clarithromycin resistance, which were highest in Hexi Corridor and Longnan regions.ConclusionThe current situation of HP resistance to common antibiotics is severe. Tetracycline is the most sensitive antibiotic, followed by amoxicillin, the first choice for HP eradication. However, the eradication failure of HP may lead to an increase in the resistance rate. Therefore, it is necessary to strengthen the standardized diagnosis and treatment of HP to improve the primary eradication rate.

Comparison of invasive histological and molecular methods in the diagnosis of Helicobacter pylori from gastric biopsies of Sudanese patients: a cross-sectional study.

Background: The continuous rise in the number of patients suffering from Helicobacter pylori is probably due to the changes in modern life. Nowadays, patients suffering from gastrointestinal problems are diagnosed through invasive and non-invasive techniques. The choice of a diagnostic test is influenced by factors such as the tests' sensitivity and specificity, the clinical conditions, and the cost-effectiveness of the testing strategy. This study aimed to compare molecular detection methods of H. pylori by polymerase chain reaction (PCR) targeting the 16S rRNA, ureA and glmM genes with an invasive histopathological technique. Methods: 290 gastric biopsies were collected using gastrointestinal endoscopy from patients with gastritis symptoms in different hospitals in Khartoum state. Two gastric biopsies were collected from each patient for PCR and histopathology. Results: A total of 103 (35.5%) samples were positive by histopathological examination, 88 (30.3%) by 16S rRNA, 39 (13.4%) by glmM gene, and 56 (19.3%) by ureA gene. The highest sensitivity was observed in 16S rRNA (46.6%), followed by glmM (24.3%) and ureA (23.3%). While the best specificity was observed in glmM gene (92.5%), followed by ureA (82.3%) and 16S rRNA (78.6%). Conclusion: PCR test targeting the 16S rRNA gene exhibited the best results for molecular detection of H. pylori compared to other genes.

Diagnostic Accuracy of Serologic (IGG) in Diagnosis of Helicobacter Pylori among Patients of Dyspepsia by Taking Stool Antigen (HPSA) as Gold Standard

Objective: To determine the diagnostic accuracy of serologic (IgG) in the diagnosis of Helicobacter Pylori among patients of dyspepsia by taking Helicobacter pylori Stool Antigen (HpSA) as the gold standard. Material and methods: The study was conducted in Microbiology Department, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi with the collaboration of gastroenterology OPD. All the patients with a history of dyspepsia, above 25 years of age and of either gender were included. After taking informed consent the clinical samples of blood and stool from patients were taken. A 6 ml venous blood was taken from the antecubital vein for detecting IgG antibody to H. pylori. Stool samples were collected for detecting H. pylori antigen in a wide mouth, sterile, leak proof container properly labeled by serial number and stool samples were stored in a refrigerator at 4°C up to 72h. On the specimens containing H. pylori antibodies, a colored line appeared in the test line region consider a positive result. H. pylori antigen was detected in stool (HpSA) by rapid chromatographic immunoassay. During analysis, the specimen responds with an anti-H. pylori antibody-coated particle. By capillary action, the mixture migrates upward on the membrane, reacting with anti-H. pylori antibodies on the membrane to produce a colorful line. A positive result is indicated by the presence of this colored line in the test zone, whereas a negative result is indicated by its absence. All the data were obtained using a study proforma, and the data was analyzed using SPSS version 26. Results: A total of 210 patients presented with dyspepsia were studied, their mean age was 49.07±10.97 and females were in majority (71.9%). H. Pylori was positive among 137 cases, those who underwent serological test (IgG) and 127 were positive for stool antigen (HpSA). The diagnostic accuracy of serological test (IgG) was found 95.23% by taking Stool Antigen (HpSA) test gold standard followed by sensitivity 92.7%, specificity 100%, PPV 100% and NPV 87.95%. Conclusion: The diagnostic accuracy of serological test (IgG) was found 95.23% by taking Stool Antigen (HpSA) test gold standard followed by sensitivity 92.7%, specificity 100%, PPV 100% and NPV 87.95%. Key words: H. pylori, diagnosis, IgG, Stool antigen

Comparison of invasive histological and molecular methods in the diagnosis of Helicobacter pylori from gastric biopsies of Sudanese patients: a cross-sectional study

Background: The continuous rise in the number of patients suffering from Helicobacter pylori is probably due to the changes in modern life. Nowadays, patients suffering from gastrointestinal problems are diagnosed through invasive and non-invasive techniques. The choice of a diagnostic test is influenced by factors such as the tests' sensitivity and specificity, the clinical conditions, and the cost-effectiveness of the testing strategy. This study aimed to compare molecular detection methods of H. pylori by polymerase chain reaction (PCR) targeting the 16S rRNA, ureA and glmM genes with an invasive histopathological technique. Methods: 290 gastric biopsies were collected using gastrointestinal endoscopy from patients with gastritis symptoms in different hospitals in Khartoum state. Two gastric biopsies were collected from each patient for PCR and histopathology. Results: A total of 103 (35.5%) samples were positive by histopathological examination, 88 (30.3%) by 16S rRNA, 39 (13.4%) by glmM gene, and 56 (19.3%) by ureA gene. The highest sensitivity was observed in 16S rRNA (46.6%), followed by glmM (24.3%) and ureA (23.3%). While the best specificity was observed in glmM gene (92.5%), followed by ureA (82.3%) and 16S rRNA (78.6%). Conclusion: PCR test targeting the 16S rRNA gene exhibited the best results for molecular detection of H. pylori compared to other genes.

Comparison of invasive histological and molecular methods in the diagnosis of Helicobacter pylori from gastric biopsies of Sudanese patients: a cross-sectional study.

Background: The continuous rise in the number of patients suffering from Helicobacter pylori is probably due to the changes in modern life. Nowadays, patients suffering from gastrointestinal problems are diagnosed through invasive and non-invasive techniques. The choice of a diagnostic test is influenced by factors such as the tests' sensitivity and specificity, the clinical conditions, and the cost-effectiveness of the testing strategy. This study aimed to compare molecular detection methods of H. pylori by polymerase chain reaction (PCR) targeting the 16S rRNA, ureA and glmM genes with an invasive histopathological technique. Methods: 290 gastric biopsies were collected using gastrointestinal endoscopy from patients with gastritis symptoms in different hospitals in Khartoum state. Two gastric biopsies were collected from each patient for PCR and histopathology. Results: A total of 103 (35.5%) samples were positive by histopathological examination, 88 (30.3%) by 16S rRNA, 39 (13.4%) by glmM gene, and 56 (19.3%) by ureA gene. The highest sensitivity was observed in 16S rRNA (46.6%), followed by glmM (24.3%) and ureA (23.3%). While the best specificity was observed in glmM gene (92.5%), followed by ureA (82.3%) and 16S rRNA (78.6%). Conclusion: PCR test targeting the 16S rRNA gene exhibited the best results for molecular detection of H. pylori compared to other genes.

Diagnosis of histological gastritis based on the Kyoto classification of gastritis in Japanese subjects – including evaluation of aging and sex difference of histological gastritis

Objectives The Kyoto classification of gastritis was established for diagnosing Helicobacter pylori (H. pylori) infection via endoscopic findings. We investigated the role of the Kyoto classification of gastritis in the diagnosis of H. pylori infection and histological gastritis in Japanese individuals. Moreover, the histological findings of gastritis in H. pylori infection were examined based on age and sex differences. Methods We selected 561 patients aged 20–79 years who underwent gastroduodenal endoscopy at our hospital between 2010 and 2018. Endoscopic biopsy specimens from the antrum and corpus were used to investigate H. pylori infection and histology. Endoscopic findings were based on the Kyoto classification of gastritis, and histological findings were based on the updated Sydney System. Results Endoscopic findings based on the Kyoto classification of gastritis (H. pylori positive, 303 patients; H. pylori negative, 258 patients, based on endoscopic findings) had 98.7% sensitivity and 98.4% specificity for histological gastritis. In addition, endoscopic findings in the three age groups (20–39, 40–59, and 60–79 years) had high sensitivity and specificity. Atrophy and intestinal metaplasia were found only in the H. pylori-positive group and progressed with age. Histological inflammation of pyloric mucosa in the younger age group of H. pylori-positive patients was significantly higher than that in the elderly group. Significant inflammation was observed in young women. Conclusions The Kyoto classification of gastritis can not only diagnose H. pylori infection but also detect histological gastritis. Histological gastritis has varying characteristics of inflammation, atrophy, and intestinal metaplasia, depending on age and sex.

Rapid Urease Test vs Histopathological Examination: A Prospective Study to Compare the Accuracy of Both Tests in the Diagnosis of Helicobacter pylori

Background: Helicobacter pylori is a gram-negative bacterium that causes chronic gastritis and plays important role in peptic ulcer disease, gastric carcinoma, and gastric lymphoma. The main aim and objective of the study were to study the incidence of H. pylori. To find the efficacy of rapid urease test (RUT) and histopathological examination of gastric biopsy in diagnosing H. pylori organism.&#x0D; Methods: This study was conducted at saveetha medical college and hospitals for 6 months. A comparative study between rapid urease test and histopathological examination to diagnose H. pylori infection. Some 100 patient with gastritis was taken for this study.&#x0D; Result: A total No of patients 100 (100%) were taken for this study in which 64 patients were detected positive for H. pylori by RUT method and 63 patients were detected positive for H. pylori by HPE method.The total no of cases positive for both RUT and HPE is 60.An association between RUT and HPE finding in the study group with the sensitivity being 95.24%, specificity being 89.19%, positive predictive value 93.75%, negative predictive valve 91.67% and accuracy 93.00%.&#x0D; Conclusion: Our study shows when comparing rapid urease test and histopathological examination. RUT and HPE show the same level of accuracy in the diagnosis of H. pylori infection. Since the rapid urease test is a rapid technique to perform so it is a good alternative for histological examination in a resource-poor environment.

Comparison Between Real-time Ammonium and pH Measurement, Immunohistochemistry, and Histochemistry for the Diagnosis of Helicobacter pylori.

Helicobacter pylori (HP) infection has been implicated in several malignant and nonmalignant conditions. The confirmatory diagnosis of HP requires an endoscopic biopsy, followed by a rapid urease test, culture, and/or histopathologic examination using hemotoxylin and eosin, histochemical stains, or immunohistochemistry against HP. EndoFaster is a novel device that can perform real-time ammonium and pH measurements in gastric juice, allowing a diagnosis of HP during gastroduodenal endoscopy. This study aimed to validate the accuracy of EndoFaster and to compare different histochemical and immunohistochemical techniques for the diagnosis of HP infection. Consecutive patients who underwent upper endoscopy at our center were prospectively enrolled. During the endoscopy procedure, gastric juice was aspirated to perform an automatic analysis by EndoFaster and gastric biopsies were taken. Histologic sections were reviewed to assess the histopathologic features. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for the EndoFaster test, Diff-Quick (DQ), and immunohistochemistry against HP (anti-HP) using Warthin-Starry as the gold standard for HP detection. Overall, 80 patients were enrolled. In 19 cases (23,75%), histology was normal. In the remaining cases, varying degrees of inflammation were found. The sensitivity, specificity, positive predictive value, and negative predictive value were 73.33%, 86.00%, 75.86%, and 84.31% for the EndoFaster test using 67 ppm/mL as the positive threshold; 73.33%, 100%, 100%, and 86.21% for DQ; and 79.31%, 88.00%, 79.31%, and 88.00% for anti-HP, respectively. The EndoFaster test has good sensitivity and specificity for the diagnosis of HP during the gastroscopy procedure. DQ and anti-HP are excellent alternatives to Warthin-Starry for the detection of HP.