Document Detail


Real-time PCR for diagnosing Helicobacter pylori infection in patients with upper gastrointestinal bleeding: comparison with other classical diagnostic methods.
MedLine Citation:
PMID:  22837325     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to determine the diagnostic usefulness of quantification of the H. pylori genome in detection of infection in patients with upper gastrointestinal bleeding (UGB). A total of 158 consecutive patients with digestive disorders, 80 of whom had clinical presentation of UGB, were studied. The number of microorganisms was quantified using a real-time PCR system which amplifies the urease gene with an internal control for eliminating the false negatives. A biopsy sample from the antrum and corpus of each patient was processed. The rapid urease test, culture, histological study, stool antigen test, and breath test were done. The gold standard was a positive culture or positive results in at least two of the other techniques. When a positive result was defined as any number of microorganisms/human cell, the sensitivity of real-time PCR was greater in bleeding patients, especially in the gastric corpus: 68.4% (95% confidence interval [CI], 52.3 to 84.5%) in non-UGB patients versus 91.5% (95% CI, 79.6 to 97.6%) in UGB patients. When a positive result was defined as a number of microorganisms/human cell above the optimal value that maximizes the Youden index (>3.56 microorganisms/human cell in the antrum and >2.69 in the corpus), the sensitivity and specificity in UGB patients were over 80% in both antrum and corpus. Our findings suggest that some bleeding patients with infection caused by H. pylori may not be correctly diagnosed by classical methods, and such patients could benefit from the improved diagnosis provided by real-time PCR. However, the clinical significance of a small number of microorganisms in patients with negative results in classical tests should be evaluated.
Authors:
Jesús Saez; Sofía Belda; Miguel Santibáñez; Juan Carlos Rodríguez; Javier Sola-Vera; Antonio Galiana; Montserrat Ruiz-García; Alicia Brotons; Elena López-Girona; Eva Girona; Carlos Sillero; Gloria Royo
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Publication Detail:
Type:  Journal Article     Date:  2012-07-25
Journal Detail:
Title:  Journal of clinical microbiology     Volume:  50     ISSN:  1098-660X     ISO Abbreviation:  J. Clin. Microbiol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-14     Completed Date:  2013-01-09     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  7505564     Medline TA:  J Clin Microbiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3233-7     Citation Subset:  IM    
Affiliation:
S. Medicina Digestiva, Hospital General Universitario de Elche, Elche, Alicante, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bacterial Proteins / genetics
Bacteriological Techniques / methods*
Female
Gastrointestinal Hemorrhage / microbiology
Helicobacter Infections / complications,  diagnosis*,  microbiology*
Helicobacter pylori / genetics,  isolation & purification*
Humans
Male
Middle Aged
Molecular Diagnostic Techniques / methods*
Prospective Studies
Real-Time Polymerase Chain Reaction / methods*
Sensitivity and Specificity
Urease / genetics
Chemical
Reg. No./Substance:
0/Bacterial Proteins; EC 3.5.1.5/Urease
Comments/Corrections

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