ACCUSTAT WHOLE-BLOOD FINGERSTICK TEST FOR HELICOBACTER-PYLORI INFECTION - A RELIABLE SCREENING METHOD

Helicobacter pylori antibody testing is accurate for diagnosing untrea ted patients. Rapid serum testing is as accurate as formal enzyme-link ed immunosorbent assay (ELISA) testing. As whole blood fingerstick tes ts may become the diagnostic method of choice if they are of similar a ccuracy, 51 patients were studied who had not taken antibiotics, bismu th, sucralfate, or proton pump inhibitors. Concordance between C-14 Ur ea Breath Testing and HM-CAP ELISA testing served as the study standar d for H. pylori diagnosis. Rapid antibody testing was performed with t he AccuStat whole blood (Boehringer Mannheim, Mannheim, Germany) and F lexSure HP (Smith Kline Diagnostics, San Jose, CA) serum tests. Antral biopsy for CLO testing and histological evaluation with thiazine stai ning were available for 18 (35.3%) and 20 patients (39.2%), respective ly. Nineteen of 50 patients (38%) were infected. (One patient had disc ordant tests and was excluded.) FlexSure HP and AccuStat were each pos itive in 18 (36%) and 19 patients (38%) with sensitivity, specificity, and positive and negative predictive values of 89.5% and 89.5%, 96.8% and 93.5%, 94.4% and 89.5%, and 93.8% and 93.5%, respectively. There were two false-negative FlexSure HP and AccuStat tests and three false -positive tests-1 FlexSure and 2 AccuStat results. CLO test and histol ogy concurred in every case tested. We conclude that both rapid antibo dy tests are accurate and suitable for screening patients not previous ly treated for H. pylori infection. Since the AccuStat has preserved d iagnostic strength, is less costly, takes less time, and is less labor intensive, whole blood testing is the screening test of choice.