Monoclonal Enzyme Immunoassay Research Articles

Prospective, study comparing the accuracy of two different stool antigen tests (Premier Platinum HpSA and novel ImmunoCard STAT! rapid test) for the diagnosis of Helicobacter pylori infection

BackgroundAt present only monoclonal EIA (enzyme-immunoassay) stool antigen-tests have obtained optimal accuracy in the diagnosis of Helicobacter pylori. Our aim was to evaluate the accuracy of two stool antigen-tests, the validated Premier Platinum HpSA PLUS (EIA test) and the newly available ImmunoCard STAT! HpSA HD (rapid test) for the initial diagnosis and the confirmation of eradication of H. pylori infection. Patients and methodsPatients with indication of H. pylori diagnosis, or confirmation after treatment were included. Data were coded to protect personal data and ensure blindness between tests. Accuracy was considered as coincident diagnosis with the gold standard (13C-urea breath test, UBT). The EIA was used as a bench standard. All stool tests were performed in duplicate. Results264 patients completed the protocol (100 naïve, 164 post-eradication). Average age was 52 years, 61% women, 11% ulcer. Positive diagnoses by UBT were 41% for naïve and 17% for post-eradication. Overall ImmunoCard and EIA accuracies were respectively 91% (95%C.I.=88–94%) and 89% (86–93%), sensitivities 72% (67–78%) and 72% (67–78%), and specificities 98% (96–100%), and 95% (92–97%). Concordance between ImmunoCard and EIA was 95% (93–98%). DiscussionOur results indicate that the newly available ImmunoCard rapid stool antigen-test achieves 90% accuracy, with high specificity but suboptimal sensitivity. The ImmunoCard attained equivalent accuracies as the EIA bench standard, with 95% concordance.

Comparison of the Diagnostic Accuracy of Five Different Stool Antigen Tests for the Diagnosis of Helicobacter pylori Infection

Several noninvasive diagnostic tests based on the detection of Helicobacter pylori stool antigen (HpSA) have been developed. The aim of the study was to compare the diagnostic accuracy of 5 HpSA tests-2 monoclonal enzyme immunoassay tests (EIAs: the Premier Platinum HpSA Plus test and Helicobacter pylori Antigen (Hp Ag) test) and 3 rapid immunochromatographic assay (ICA) tests (the ImmunoCard STAT! HpSA test, one step HpSA test, and H. pylori fecal antigen test)--for diagnosing H. pylori infection in adult patients with dyspeptic symptoms before eradication therapy. A total of 198 patients with dyspeptic symptoms were included in the study. A gastric biopsy was collected for histopathology and rapid urease testing. Stool specimens for HpSA testing were also collected. Patients were considered H. pylori positive if two invasive tests (histological and rapid urease tests) were positive. The sensitivity and specificity were 92.2% and 94.4%, respectively, for the Premier Platinum HpSA Plus test; 48.9% and 88.9%, respectively, for the HP Ag test; 86.7% and 88.9, respectively, for the One Step HpSA test; 68.9% and 92.6%, respectively, for the ImmunoCard STAT! HpSA test; and 78.9% and 87%, respectively, for the H. Pylori fecal antigen test. The Premier Platinum HpSA Plus EIA test was determined to be the most accurate stool test for diagnosing H. pylori infections in adult dyspeptic patients. The currently available ICA-based tests are fast and easy to use but provide less reliable results.

Antigenic and Molecular Characterization of Unusual Rotavirus Strains in Burkina Faso in 1999

Thirty-six of 37 rotavirus strains recovered from the diarrheal stools of 166 children <3 years of age in Burkina Faso were characterized at both the antigenic and molecular levels. The rotavirus strains were confirmed by polyacrylamide gel electrophoresis; 30 displayed predominantly short electropherotype patterns, and 6 had a long RNA pattern. The strains were subgrouped by monoclonal antibody enzyme immunoassay for VP6 and were typed as subgroup I (29 of 30 short rotavirus strains) and subgroup II (5 of 6 long strains). The VP7 serotyping and genotyping showed that all 6 viruses with long electropherotype patterns were G1. The short strains were determined to be VP7 serotype G2 by reverse-transcription polymerase chain reaction (PCR) in 27 strains and nucleic acid sequencing of selected strains, although only 1 reacted with the G2-specific monoclonal antibodies. Finally, the short patterns were shown by the PCR genotyping method to be VP4 genotype P[6], and the long patterns were shown to be P[8]. The predominant strain found in Burkina Faso in this small study was an unusual G2P[6] strain that showed a short RNA electropherotype and VP6 subgroup I specificity and failed to react with a panel of G2-specific monoclonal antibodies.

Improved Performance of a Rapid Office-Based Stool Test for Detection of Helicobacter pylori in Children before and after Therapy

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 [(13)C]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 [(13)C]urea breath test are not available or feasible. In order to improve sensitivity, very weak lines should be considered positive test results.

Usefulness and influence of age of a novel Rapid HpStAR™ stool antigen for the diagnosis of Helicobacter pylori infection in children

A novel rapid monoclonal enzyme immunoassay stool antigen for Helicobacter pylori detection (Rapid HpStAR™) was evaluated in 16 infected and 92 noninfected children. The overall sensitivity, specificity, and positive and negative predictive values were 87.5%, 97.8%, 87.5%, and 97.8%, respectively, with an accuracy of 96.2%. The negative predictive value was good in all age groups, reaching 100% in younger children.

Vasular endothelial cell growth factor (VEGF): a new tumour marker in breast cancer?

<h3>Background</h3> We investigated the role of vascular endothelial cell growth factor (VEGF) in breast cancer. <h3>Methods</h3> VEGF, CA 15-3, CEA and TPA were determined over a period of 18 months in the department of Gynaecology and Obstetrics at the Technical University Dresden, Germany. The investigation was conducted on 314 sera from patients with previously diagnosed breast cancer. They had undergone surgery and were classified in stages 0–IV according the TNM classification. The control group was composed of 58 sera from healthy women aged 23–84 years old. VEGF was measured according to the sandwich principle with a monoclonal enzyme immunoassay (EIA) from R&D Systems (USA) and CA 15-3, CEA and TPA were measured with a monoclonal immunoluminometric assay (ILMA) from DiaSorin Deutschland GmbH (Germany). <h3>Results</h3> The median of all four parameters increased with the tumour stages. Only VEGF had a high decrease between stages 3 and 4. The differences of the values between the control group and stages 0–3 were only significant for VEGF and TPA. The combination of TPA and VEGF had the highest sensitivities for stages 0–3. <h3>Conclusion</h3> It can be suggested that VEGF plays crucial roles in the promotion of angiogenesis in breast cancer. However, this investigation also shows that tumour markers are not used for definitive diagnosis, they are used as aids to help physicians make decisions, after combining other clinical and diagnostic data.

Diagnosis of Helicobacter pylori Infection in a High‐prevalence Pediatric Population: A Comparison of 2 Fecal Antigen Testing Methods and Serology

Accurate methods for diagnosing active Helicobacter pylori infection in children have been limited to invasive or time-consuming techniques. Recently, fecal antigen testing has been used successfully for the diagnosis of H pylori infection in the pediatric population. We compared 2 monoclonal fecal antigen diagnostic methods in a population of children with a suspected high prevalence of H pylori infection. We also assessed the diagnostic performance of H pylori immunoglobulin G serology. In a cross-sectional study of African refugee children (<16 years) we compared an immunochromatographic technique (ICT) and serology with a monoclonal fecal antigen enzyme immunoassay (MFAT) method for the detection of active H pylori infection. Following the manufacturer's instructions, an optical density of >or=0.190 was used as a cutoff for MFAT. Sensitivity, specificity, and positive and negative predictive values were calculated. Of the 193 eligible children enrolled, active H pylori infection was detected in 149 of 182 (81.9%) in whom MFAT was performed. The prevalence of active infection increased with age; children with active infection were significantly older, and there were no sex differences. ICT and serology underperformed in comparison with MFAT (ICT sensitivity 74.6%, specificity 63.6%, positive predictive value 89.8%, negative predictive value 36.8%; and serology sensitivity 57.9%, specificity 77.4%, positive predictive value 92.0%, negative predictive value 29.9%). Monoclonal enzyme immunoassay fecal antigen testing is a practical and feasible alternative to traditional invasive diagnostic methods in high-prevalence pediatric populations. Neither immunochromatography nor serology is useful for the diagnosis of active H pylori infection in these children.

Evaluation of a novel rapid one-step monoclonal chromatographic immunoassay for detection of Helicobacter pylori in stool from children

A new rapid office-based one-step monoclonal immunoassay (RAPID Hp StAR, DakoCytomation, Cambridge, UK) for detection of Helicobacter pylori antigen in stool was evaluated in children against invasive diagnostic methods and compared to the results of a monoclonal EIA targeting the same antigen (Amplified IDEIA Hp StAR, DakoCytomation, Cambridge, UK). Coded stool samples from 118 symptomatic children (0.3-18.8 years) were investigated prior to any anti-H. pylori therapy. Fifty-four children were H. pylori infected defined by positive culture and/or two other positive tests ((13)C-urea breath test, histology, rapid urea test), the remaining 64 children showed concordant negative results. Thirty-four infected children (4.8-17.8 years) were monitored with (13)C-urea breath test (five remained positive) and stool test 6-8 weeks after anti-H. pylori therapy. The immunoassays were independently read by two investigators. The monoclonal EIA showed excellent sensitivity and specificity before (98% and 100%, respectively) and after therapy (100%; 96.2%). The rapid immunoassay was invalid for technical reasons in nine samples (5.9%). The two observers agreed in 31 positive and 93 negative results, but had discordant results in 17 samples (11.2%). Overall, the rapid test showed a poor sensitivity (63.8%-71.1%), but a good specificity (91.1%-96.2%) before treatment. We conclude that the new office based monoclonal enzyme immunoassay for diagnosis of H. pylori should be modified to improve sensitivity, inter-observer-variability and some technical problems. In contrast, the monoclonal EIA stool test is highly reliable, both pre- and post therapy, and equivalent to the (13)C-urea breath test.

Arachidonic acid cascade and epithelial barrier function during Caco-2 cell differentiation

The small intestinal epithelium is a highly dynamic system continuously renewed by a process involving cell proliferation and differentiation. The intestinal epithelium constitutes a permeability barrier regulating the vectorial transport of ions, water, and solutes. Morphological changes during cell differentiation, as well as changes in the activity of brush-border enzymes and the expression of transport proteins, are well established. However, little is known about the arachidonic acid (AA) cascade underlying epithelial cell differentiation or its role in the development of epithelial barrier function. The main purpose of this study was to examine the activity of the high-molecular-weight phospholipases A(2) (PLA(2)) and cyclooxygenase (COX) pathway during differentiation, with particular emphasis on paracellular permeability. PLA(2) activity, AA release, COX-2 expression, prostaglandin E(2) (PGE(2)) production, and paracellular permeability were studied in preconfluent, confluent, and differentiated Caco-2 cell cultures. Our results show that Caco-2 differentiation induces a decrease in both calcium-independent PLA(2) activity and COX-2 expression and, consequently, a decrease in AA release and PGE(2) synthesis in parallel with a reduction in paracellular permeability. Moreover, the addition of PGE(2) to differentiated cells, at concentrations similar to those detected in nondifferentiated cultures, induces the disruption of epithelial barrier function. These results suggest that AA release by calcium-independent PLA(2), COX-2 expression, and subsequent PGE(2) release are important for the maintenance of paracellular permeability in differentiated Caco-2 cells.

Comparison of a monoclonal with a polyclonal antibody‐based enzyme immunoassay stool test in diagnosing Helicobacter pylori infection before and after eradication therapy

Detection of Helicobacter pylori antigen in stool samples has been a subject of controversy. However, it has been included in several clinical guidelines as a recommended non-invasive testing procedure in dyspeptic patients. To compare a monoclonal enzyme immunoassay for detection of H. pylori stool antigen (Amplified IDEIA HpStAR, DakoCytomation) with a polyclonal enzyme immunoassay (HpSA test, Premier Platinum HpSA, Meridian Diagnostics) in diagnosing infection and in determining H. pylori status after eradication treatment. We evaluated stool samples of 198 patients diagnosed with H. pylori infection and of 41 patients without infection. The results of the monoclonal enzyme immunoassay HpStAR were compared with those of the polyclonal enzyme immunoassay HpSA. The sensitivity and specificity of HpStAR were 91.9% and 70.7%, while those of HpSA were 89.4% and 80.5%, respectively. In the 126 patients evaluated 6 weeks after eradication therapy, the overall agreement between urea breath test and HpStAR was 90.5% (P = 0.710) and between urea breath test and HpSA was 76.9% (P = 0.410). HpStAR is a rapid and easy-to-perform test with similar sensitivity to HpSA in the diagnosis of H. pylori infection, although it had lower specificity. In contrast, HpStAR is more accurate after eradication therapy than HpSA.

Multiple‐step polyclonal versus one‐step monoclonal enzyme immunoassay in the detection of Helicobacter pylori antigen in the stools of children

Abstract Objective: Evaluation of a polyclonal and a monoclonal Helicobacter pylori stool antigen test (HpSAT) for the detection of Helicobacter pylori (HP) infection in children. Methods: 43 children underwent a 13C‐urea breath test (13C UBT) and a HpSAT for the detection of HP. A child was considered HP positive if the 13C UBT was positive. Two HpSATs were tested: the “Premier Platinum HpSA” test (PP HpSAT) (polyclonal enzyme immunoassay) and the “ImmunoCard STAT! HpSA” test (ICS HpSAT) (one‐step immunochromatographic assay). Results: The mean age of the children was 8.9 y (range 3.5–17.5 y). Of the 43 children, 18 (41.9%) were HP positive and 25 (58.1%) were HP negative. The PP HpSAT showed a sensitivity of 94.4% and a specificity of 100.0%. With the ICS HpSAT, equivocal results occurred in 5/42 (11.9%) of the tests due to a problem with the visual interpretation of the change in colour of the test‐line. The ICS HpSAT had a sensitivity of 100.0% and a specificity of 76.0% when the test was considered positive in case of any change of colour of the test‐line, which is the correct practice according to the manufacturer. The ICS HpSAT had a sensitivity of 100.0% and a specificity of 96.0% when the test was considered positive only in case of a “significant change of colour” of the test‐line. Conclusion: Compared to the 13C UBT, the PP HpSAT shows a comparably good sensitivity and specificity, the ICS HpSAT has a comparably good sensitivity but lower specificity due to a high percentage of equivocal results when the test is used according to the manufacturer's instructions, and the ICS HpSAT has a comparably good sensitivity and specificity when a weakly positive test is considered negative for the diagnosis of HP infection in children. The ICS HpSAT is easy to perform with results available within 10 min, and is therefore of particular interest in ambulatory medicine.

Multiple-step polyclonal versus one-step monoclonal enzyme immunoassay in the detection of Helicobacter pylori antigen in the stools of children

Evaluation of a polyclonal and a monoclonal Helicobacter pylori stool antigen test (HpSAT) for the detection of Helicobacter pylori (HP) infection in children. 43 children underwent a 13C-urea breath test (13C UBT) and a HpSAT for the detection of HP. A child was considered HP positive if the 13C UBT was positive. Two HpSATs were tested: the "Premier Platinum HpSA" test (PP HpSAT) (polyclonal enzyme immunoassay) and the "ImmunoCard STAT! HpSA" test (ICS HpSAT) (one-step immunochromatographic assay). The mean age of the children was 8.9 y (range 3.5-17.5 y). Of the 43 children, 18 (41.9%) were HP positive and 25 (58.1%) were HP negative. The PP HpSAT showed a sensitivity of 94.4% and a specificity of 100.0%. With the ICS HpSAT, equivocal results occurred in 5/42 (11.9%) of the tests due to a problem with the visual interpretation of the change in colour of the test-line. The ICS HpSAT had a sensitivity of 100.0% and a specificity of 76.0% when the test was considered positive in case of any change of colour of the test-line, which is the correct practice according to the manufacturer. The ICS HpSAT had a sensitivity of 100.0% and a specificity of 96.0% when the test was considered positive only in case of a "significant change of colour" of the test-line. Compared to the 13C UBT, the PP HpSAT shows a comparably good sensitivity and specificity, the ICS HpSAT has a comparably good sensitivity but lower specificity due to a high percentage of equivocal results when the test is used according to the manufacturer's instructions, and the ICS HpSAT has a comparably good sensitivity and specificity when a weakly positive test is considered negative for the diagnosis of HP infection in children. The ICS HpSAT is easy to perform with results available within 10 min, and is therefore of particular interest in ambulatory medicine.

Accuracy of a new monoclonal stool antigen test in post-eradication assessment of Helicobacter pylori infection: Comparison with the polyclonal stool antigen test and urea breath test

Background and aim. The enzyme immunoassay based on polyclonal antibodies (HpSA) represents a valid method for the detection of Helicobacter pylori antigens in stool specimens, but some controversial results were reported in post-eradication setting. A new monoclonal enzyme immunoassay (FemtoLab H. pylori, Connex) has been developed. The present study compares the diagnostic accuracy of the two tests after eradication therapy. Patients and methods. Stool samples were collected and urea breath test and endoscopy performed in 325 patients (161 F, 164 M, age 17–78 years), 4–8 weeks after standard triple eradication therapy. The FemtoLab and HpSA tests were performed in accordance with the manufacturer's protocol. H. pylori infection was confirmed if culture alone or both urease test and histology were positive and was considered absent if all three tests were negative. Results. H. pylori was eradicated in 231 patients (71.1%). Urea breath test showed the best performances with sensitivity 98.9% and specificity 99.5%. The sensitivity of FemtoLab was 88.3%, specificity 94.8%, positive and negative predictive values 87.4% and 95.2%. Corresponding HpSA values were 73.4%, 97.8%, 93.2% and 90%. Sensitivity and negative predictive value of FemtoLab were significantly better than HpSA. Adjusting the cut-offs according to a ROC curve improved not significantly the sensitivity of the two tests. Conclusions. Urea breath test shows the best accuracy in the assessment of H. pylori infection. Between the stool tests, the FemtoLab due to its higher sensitivity is to prefer in the post-eradication assessment of H. pylori infection.

Usefulness and influence of age of a novel rapid monoclonal enzyme immunoassay stool antigen for the diagnosis of Helicobacter pylori infection in children

A novel rapid monoclonal enzyme immunoassay stool antigen for Helicobacter pylori detection (Immunocard STAT!HpSA®, Meridian Diagnostic Inc , Cincinnati, OH) was evaluated in 29 infected and 99 noninfected children. The overall sensitivity, specificity, and positive and negative predictive values were 86.2%, 92.9%, 78.1%, and 95.8%, respectively, with an accuracy of 91.4%. The highest performance was observed in children older that 10 years, with a sensitivity level of 100%, contrasting with a lower level, 75%, in those younger than 5 years. A good negative predictive value was observed in all age groups, particularly in older children achieving 100%.

Comparison of Invasive and Non‐Invasive Tests Diagnosis and Monitoring of Helicobacter Pylori Infection in Children

ABSTRACTBackground:There are few reports which the tests used for diagnosing Helicobacter pylori infection and monitoring its eradication in children.Study Aims:Prospective evaluation of invasive (gastric histology, rapid urease test [RUT]) and non‐invasive (stool antigen [FemtoLab H. pylori], urea breath test [UBT]) tests in the diagnosis of H. pylori infection and post‐treatment eradication in children and adolescents.Methods:Ninety‐two patients (50 male, 42 female) referred for upper gastrointestinal endoscopy were prospectively enrolled. UBT was performed and stool specimens collected for monoclonal enzyme immunoassay for H. pylori antigen (FemtoLab) 1 to 4 days before endoscopy. H. pylori in gastric biopsies was evaluated by RUT and staining with hematoxylin‐eosin and giemsa. Eradication therapy was given to children with abdominal pain and H. pylori gastritis. FemtoLab H. pylori and UBT were repeated 6 weeks after the end of triple therapy.Results:Histology identified H. pylori in 49 of 92 (53%) subjects. Concordance between histology and RUT was found in 78 of 92 children. FemtoLab H. pylori was positive in 41 of 78 (52.6%) children with sensitivity, specificity, positive and negative predictive values of 97.5%, 94.7%, 95.1% and 97.3%, respectively. For UBT, these values were 100%, 96.9%, 97.5% and 100%, respectively. Twenty‐six of 36 patients who received triple therapy returned for eradication evaluation. Tests for H. pylori antigen in stool were positive in 10 of 26 and for UBT in 11 of 26.Conclusion:Stool antigen (FemtoLab) and UBT were equally effective in diagnosing and confirming eradication of H. pylori infection in children.

Comparison of Invasive and Non-Invasive Tests Diagnosis and Monitoring of Helicobacter Pylori Infection in Children

There are few reports which the tests used for diagnosing Helicobacter pylori infection and monitoring its eradication in children. Prospective evaluation of invasive (gastric histology, rapid urease test [RUT]) and non-invasive (stool antigen [FemtoLab H. pylori], urea breath test [UBT]) tests in the diagnosis of H. pylori infection and post-treatment eradication in children and adolescents. Ninety-two patients (50 male, 42 female) referred for upper gastrointestinal endoscopy were prospectively enrolled. UBT was performed and stool specimens collected for monoclonal enzyme immunoassay for H. pylori antigen (FemtoLab) 1 to 4 days before endoscopy. H. pylori in gastric biopsies was evaluated by RUT and staining with hematoxylin-eosin and giemsa. Eradication therapy was given to children with abdominal pain and H. pylori gastritis. FemtoLab H. pylori and UBT were repeated 6 weeks after the end of triple therapy. Histology identified H. pylori in 49 of 92 (53%) subjects. Concordance between histology and RUT was found in 78 of 92 children. FemtoLab H. pylori was positive in 41 of 78 (52.6%) children with sensitivity, specificity, positive and negative predictive values of 97.5%, 94.7%, 95.1% and 97.3%, respectively. For UBT, these values were 100%, 96.9%, 97.5% and 100%, respectively. Twenty-six of 36 patients who received triple therapy returned for eradication evaluation. Tests for H. pylori antigen in stool were positive in 10 of 26 and for UBT in 11 of 26. Stool antigen (FemtoLab) and UBT were equally effective in diagnosing and confirming eradication of H. pylori infection in children.

Diagnosis of Helicobacter pylori infection in dyspeptic patients by stool antigen detection : Usefulness of a new monoclonal enzyme immunoassay test

Background. Helicobacter pylori antigens can be measured in human stools with an enzyme immunoassay, which may prove to be a valuable non-invasive diagnostic tool. Aim. To evaluate the usefulness of a new monoclonal enzyme immunoassay for detecting H. pylori antigens in dyspeptic patients’ faeces (FemtoLab H. pylori, Connex, Martinsried, Germany). Patients. H. pylori infection was determined in 75 patients (49 men, 26 women, mean age 52±16.5) for histology and rapid urease test. Methods. H. pylori status was established by concordance of the reference tests. FemtoLab H. pylori was measured in triplicate. In addition, two determinations of a polyclonal faecal antigen test (HpSA, Platinum Premier HpSA™, Meridian Diagnostic Inc., Cincinnati, USA) were also performed. Sensitivity, specificity, positive and negative predictive values were calculated. Concordance between different measurements was estimated by Kappa statistics. Results. The sensitivity of the FemtoLab H. pylori immunoassay ranged from 98 to 100% and its specificity was 76%. Positive and negative predictive values were 91 and 94–100%, respectively. Concordance coefficients ranged from 0.81 to 0.92. Corresponding HpSA values were 69, 86, 92 and 53%, respectively. Concordance coefficient was 0.61. Conclusions. FemtoLab H. pylori is a very sensitive, specific, highly reproducible and easy-to-perform tool for diagnosis of H. pylori infection.

A comparison between monoclonal and policlonal enzyme immunoassay for assessment of H. pylori infection in stool after eradication treatment

A comparison between monoclonal and policlonal enzyme immunoassay for assessment of H. pylori infection in stool after eradication treatment

Risk of Occupational Exposure to &lt;I&gt;Cryptosporidium, Giardia,&lt;/I&gt; and &lt;I&gt;Campylobacter&lt;/I&gt; Associated with the Feces of Giant Canada Geese

Giant Canada geese (Branta canadensis maxima), which are nesting locally in Northwest Ohio and other parts of the state, are commonly perceived as a public nuisance when they inhabit urban areas. The feces of giant Canada geese litter both grass and pavement in many occupational and recreational sites in the Toledo area. The purpose of this study was to identify sites with fecal droppings of giant Canada geese that test positive for Cryptosporidium, Giardia, and Campylobacter, qualitatively assess the occupational risks of infections, and recommend protective measures. The fecal droppings of giant Canada geese were tested for Cryptosporidium, Giardia, and Campylobacter, using sensitive monoclonal enzyme immunoassay (EIA) methods. Fourteen out of 16 sites tested positive for at least one pathogen. None tested positive for all three. Cryptosporidium was the most common infectious organism found in the fecal droppings. It was detected in 14 out of 18 (77.8%) samples. Campylobacter was found in 7 out of 18 (3...

Risk of Occupational Exposure toCryptosporidium, Giardia,andCampylobacterAssociated with the Feces of Giant Canada Geese

Giant Canada geese (Branta canadensis maxima), which are nesting locally in Northwest Ohio and other parts of the state, are commonly perceived as a public nuisance when they inhabit urban areas. The feces of giant Canada geese litter both grass and pavement in many occupational and recreational sites in the Toledo area. The purpose of this study was to identify sites with fecal droppings of giant Canada geese that test positive for Cryptosporidium, Giardia, and Campylobacter, qualitatively assess the occupational risks of infections, and recommend protective measures. The fecal droppings of giant Canada geese were tested for Cryptosporidium, Giardia, and Campylobacter, using sensitive monoclonal enzyme immunoassay (EIA) methods. Fourteen out of 16 sites tested positive for at least one pathogen. None tested positive for all three. Cryptosporidium was the most common infectious organism found in the fecal droppings. It was detected in 14 out of 18 (77.8%) samples. Campylobacter was found in 7 out of 18 (38.9%) samples, and 3 out of 18 (16.7%) samples tested positive for Giardia. Since fecal droppings of giant Canada geese are dense in many sites, occupational exposure to Cryptosporidium is very plausible. In addition, fecal droppings from other carrier vertebrates are likely to be present in the same sites occupied by giant Canada geese, thereby increasing the likelihood of occupational exposure to one or more of these pathogens. It has also been suggested that houseflies and dung beetles may be mechanical carriers of Cryptosporidium. We recommend that work environments in close proximity to the nesting sites of giant Canada geese be maintained in a sanitary condition. Workers at risk for exposure should wear protective gloves while working, wash their hands after performing applicable activities and before touching their mouths, launder work clothes daily, and, ideally, shower at the end of the workday. We further recommend that potentially exposed workers who develop gastrointestinal infections have their stools tested for Cryptosporidium, Giardia, and Campylobacter.