DIAGNOSIS OF HELICOBACTER PYLORI INFECTION BY STOOL ANTIGEN DETECTION IN ADULT DYSPEPTIC PATIENTS IN BENHA UNIVERSITY HOSPITAL
1Enas Sh. Khater and 2Ayman M. EL-Badawy.
1Department of Microbiology and Immunology, Faculty of Medicine, Benha University
2Internal Medicine, Faculty of Medicine, Benha University.
Objective: The current study aimed to assess prevalence of Helicobacter pylori (H. pylori) in adult dyspeptic patients in in Benha University Hospital and to evaluate methods of detection of H. pylori in stool and in gastric biopsy, as well as, detection of H. pylori antibodies. Subjects and methods: The selected patients were 49 inpatients and outpatients complaining of dyspepsia attending Benha University hospital. They were 32 males aged 25-54 years and 17 females aged 20-51 years. All patients under study were subjected to Full clinical history and different sampling; gastric biopsy, serum and stool. Gastric samples were processed and cultured. Thereafter, microscopic examination and rapid urease tests (RUTs) were conducted. H. pylori IgG antibodies were detected by enzyme-linked immunosorbent assay (ELISA) and H. pylori antigen detection was carried out in the stool samples by RAPID Hp StAR and enzymatic immunoassay (EIA) Amplified IDEIA Hp StAR. Results: In current study endoscopic picture revealed that out of 49 patients; 36 were gastric affected. Out of 36 endoscopically gastric affected patients 32 (88.9%) were culture positive. overall prevalence of H pylori was 65.3% which was detected by culture. while IgG seroprevalence among studied patients was 59.2%. The highest prevalence of H. pylori infection was noted among 31-40 Yrs. age group. Out of 32 culture positive samples, urease test detected only 29 urease positive. Sensitivity and specificity were 90.6% (95% CI: 75% to 97.9%) and 100% (95% CI: 83% to 100%) respectively. RAPID Hp StAR for rapid detection of stool H. pylori antigen was positive in 27 (55.1%) patients. Sensitivity and specificity were 78.1% (95% CI: 60% to 90.7 %) and 88.3% (95% CI: 63.57 % to 98.2 %) respectively. Amplified IDEIA Hp StAR for detection of stool H. pylori antigen was positive in 31(63.3%) patients. Sensitivity and specificity were high 96.9% (95% CI: 83.7 % to 99.5%) and 94.1 95% (CI: 71.2 % to 99.0%) respectively. Conclusion: 1- overall prevalence of H. pylori was 65.3% as detected by culture. While IgG seroprevalence among studied patients was 59.2%. 2-stool antigen test (Amplified IDEIA Hp StAR) can be a very good standard for diagnosing H. pylori infection with high sensitivity and specificity.
June 2012