Comparison of invasive and noninvasive methods for the diagnosis and evaluation of eradication of Helicobacter pylori infection in children

Background, Acquisition of Helicobacter pylori infection occurs mainly duri ng childhood. To study the events associated with H. pylori colonization in children it is important to have reliable diagnostic methods. Our objectiv e was to validate invasive and noninvasive tests for diagnosis of H, pylori infection in children before and after antimicrobial treatment. Methods. Before treatment, invasive rapid urease test (RUT) culture and his tology, as well as the noninvasive carbon-13 urea breath test (C-13-UBT) an d serology were validated in 59 children. The gold standard for H. pylori i nfection was any of three positives of the five tests. After antimicrobial treatment culture, histology, and C-13-UBT were validated in 43 children to determine eradication. The gold standard for eradication was negative in a ll three tests, Results. For primary diagnosis, RUT was the most sensitive and specific tes t, followed by C-13-UBT, which performed better than serology, culture, and histology. Concordance tests also showed that RUT and C-13-UBT performed b etter. For determination of eradication, C-13-UBT and histology were better than culture, which showed poor sensitivity. Conclusions. RUT performed better for primary diagnosis. However, as endosc opy might not be indicated in most children, C-13-UBT could be the test of choice for diagnosis of H, pylori infection both before and after eradicati on treatment, (C) 2000 IMSS. Published by Elsevier Science Inc.