Comparison between stool antigen test and rapid urease test for Helicobacter pylori diagnosis in symptomatic cases of peptic ulcer disease at a tertiary care centre

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Keywords

Diagnosis;
Helicobacter pylori;
Peptic ulcer disease;
Rapid urease test;
Stool antigen test;
Symptomatic gastritis.

How to Cite

Jha, J. C., Koirala, P., Shah, A., Dhakal, A., Karna, R. K., & Budhathoki, A. (2023). Comparison between stool antigen test and rapid urease test for Helicobacter pylori diagnosis in symptomatic cases of peptic ulcer disease at a tertiary care centre. Journal of Kathmandu Medical College, 12(3), 174–8. Retrieved from https://jkmc.com.np/ojs3/index.php/journal/article/view/1313

Abstract

Background: Peptic ulcer disease is defined as a breach in gastric epithelium of the inner lining of the gastrointestinal tract due to imbalance between destructive gastric acid, pepsin, and protective gastric mucosa. Helicobacter pylori (H. pylori) is a gram-negative, flagellated bacilli. H. pylori infection eradication is possible with antimicrobial therapy, so its prompt and appropriate diagnosis is very important.

Objectives: To compare between the results of stool antigen test (SAT) and rapid urease test (RUT), with assessment of sensitivity and specificity.

Methods: A hospital-based descriptive cross-sectional study in department of Internal Medicine at Birat Medical College and Teaching Hospital was conducted from 2023 January 2 to 2023 July 2 after institutional ethical clearance. Symptomatic gastritis patients visited in outpatient department, admitted and who gave consent were enrolled through consecutive sampling methods in this study. Biopsy sample obtained by upper gastrointestinal endoscopy of these patients were examined by RUT. ABON™ One Step H. pylori SAT Device was used for the detection of H. pylori antigens in the Stool Specimens obtained from these patients. Microsoft Excel sheet and SPSS v.23 were used for data analysis.

Results: More than two-thirds (105, 67.7%) were positive in upper gastrointestinal endoscopy and nearly two-thirds (100, 64.5%) had positive stool antigen tests.

Conclusion: This study showed the H. pylori stool antigen test is effective non-invasive way to find out H. pylori infection demonstrating no significant difference in specificity and sensitivity in comparison to RUT and can be considered as a routine diagnostic tool for surveying clinical significance as well as eradication of H. pylori.

References

Kazemi S, Tavakkoli H, Habizadeh MR, Emami MH. Diagnostic values of helicobacter pylori diagnostic tests: Stool antigen test, urea breath test, rapid urease test, serology, and histology. J Res Med Sci. 2011 Sep;16(9):1097-104. [PubMed | Full Text]

Calik Z, Karamese M, Acar O, Aksak Karamese S, Dicle Y, Albayrak F, Can S, Guvendi B, Turgut A, Cicek M, Yazgi H. Investigation of Helicobacter pylori antigen in stool samples of patients with upper gastrointestinal complaints. Braz J Microbiol. 2016 Jan-Mar;47(1):167-71. [Full Text]

Sabbagh P, Mohammadnia-Afrouzi M, Javanian M, Babazadeh A, Koppolu V, Vasigala VR, Nouri HR, Ebrahimpour S. Diagnostic methods for Helicobacter pylori infection: ideals, options, and limitations. Eur J Clin Microbiol Infect Dis. 2019 Jan;38(1):55-66. [Full Text]

Malik TF, Gnanapandithan K, Singh K. Peptic ulcer disease. [Updated 2023 June 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534792/PMID: 30521213 [Full Text]

Feyisa ZT, Woldeamanuel BT. Prevalence and associated risk factors of gastritis among patients visiting Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia. PLoS One. 2021 Feb 9;16(2):e0246619. [Full Text]

Siavoshi F, Saniee P, Khalili-Samani S, Hosseini F, Malakutikhah F, Mamivand M, et al. Evaluation of methods for H. pylori detection in PPI consumption using culture, rapid urease test and smear examination. Ann Transl Med. 2015 Jan;3(1):11. [Full Text]

Kismat S, Tanni NN, Akhtar R, Roy CK, Rahman MM, Molla MMA, et al. Diagnosis and comparison of three invasive detection methods for helicobacter pylori infection. Microbiol Insights. 2022 Oct 28;15:11786361221133947. [Full Text]

Abadi ATB. Diagnosis of Helicobacter pylori using invasive and noninvasive approaches. J Pathog. 2018 May 22;2018:9064952. [Full Text]

Shimoyama T. Stool antigen tests for the management of Helicobacter pylori infection. World J Gastroenterol. 2013 Dec 7;19(45):8188-91. [Full Text]

Asaka M, Kato M, Kudo M, Meguro T, Kimura T, Miyazaki T, et al. The role of Helicobacter pylori in peptic ulcer disease. Gastroenterol Jpn. 1993 May;28 Suppl 5:163-7. [Full Text]

Alfau M, Delgado A, Reyes C, Durán D, Arbaje D, García A. Accuracy of stool antigen test in the diagnosis of helicobacter pylori infection in the dominican republic. Cureus. 2023 Aug 28;15(8):e44290. [Full Text]