Diagnosis of Helicobacter pylori infection from antral biopsies in pediatric patients is urease test that reliable?

Our objectives were to determine if the urease (CLO) test alone is a reliab le diagnostic test for H. pylori gastritis in children and if the density o f H, pylori influences the CLO test result. We performed a combined retrosp ective and prospective study reviewing the results of CLO-test and histolog y of gastric mucosal biopsy from 67 patients (35 females) with H. pylori ga stritis. Two antral biopsies were inoculated on the CLO-test and two proces sed for histology to grade the severity of gastritis and H. pylori density. The mean age of patients was 11 years (SD +/- 4.53). Only 50 patients test ed positive for H. pylori on CLO-test, whereas all patients were positive o n histology. The sensitivity of the CLO-test was 75%. There was a significant associatio n between CLO-test positivity and the density of H. pylori organisms on his tology (P < 0.01), and with the severity of gastritis (P < 0.001) by the Pe arson chi-square test. However, there was no association between the densit y of N. pylori and severity of gastritis. In conclusion, the CLO-test is no t reliable as a sole diagnostic test for N. pylori gastritis in children be cause of a significant number of false negatives. Histologic examination of gastric mucosal biopsy is superior to the CLO-test in diagnosing H. pylori infection.