[Validation of a rapid urease test for the diagnosis of Helicobacter pylori infection]. / Validación de un test de ureasa rápido para el diagnóstico de la infección por H. pylori.

OBJECTIVE: Several non-commercial rapid urease tests have been designed with the objective of reducing the cost of Helicobacter Pylori infection diagnosis. The objective of the present prospective trial is to assess one of these tests, using the histologic evaluation for the presence of Helicobacter Pylori, as the standard reference of diagnosing this infection. METHODS: Patients undergoing upper endoscopy for various reasons were prospectively enrolled. Three endoscopic biopsies of the antrum and three from the corpus of the stomach were taken in every patient enrolled. The specimens were evaluated by the rapid urease test on an individual basis, comparing the results with the histology assessment of the Helicobacter Pylori status, which was considered as the standard reference for the diagnosis of the infection. RESULTS: One hundred and four patients were enrolled, of which 94 were eligible. Fifty-five patients (60.43%) were infected with Helicobacter Pylori. The sensibility and specificity of the urease test evaluated at 4 hours was 65.45% and 100% respectively. The evaluation at 24 hours of the sensibility and specificity was 83% and 94% respectively. CONCLUSIONS: The non-commercial rapid urease test is a practical, fast, and cost effective method for the detection of Helicobacter Pylori infection, and its diagnostic utility is similar to the commercial test available.

Validación de un test de ureasa rápido para el diagnóstico de la infección por H. Pylori / Validation of a rapid urease test for the diagnosis of helicobacter pylori infection

OBJECTIVE: Several non-commercial rapid urease tests have been designed with the objective of reducing the cost of Helicobacter Pylori infection diagnosis. The objective of the present prospective trial is to assess one of these tests, using the histologic evaluation for the presence of Helicobacter Pylori, as the standard reference of diagnosing this infection. METHODS: Patients undergoing upper endoscopy for various reasons were prospectively enrolled. Three endoscopic biopsies of the antrum and three from the corpus of the stomach were taken in every patient enrolled. The specimens were evaluated by the rapid urease test on an individual basis, comparing the results with the histology assessment of the Helicobacter Pylori status, which was considered as the standard reference for the diagnosis of the infection. RESULTS: One hundred and four patients were enrolled, of which 94 were eligible. Fifty-five patients (60.43%) were infected with Helicobacter Pylori. The sensibility and specificity of the urease test evaluated at 4 hours was 65.45% and 100% respectively. The evaluation at 24 hours of the sensibility and specificity was 83% and 94% respectively. CONCLUSIONS: The non-commercial rapid urease test is a practical, fast, and cost effective method for the detection of Helicobacter Pylori infection, and its diagnostic utility is similar to the commercial test available

[Diagnosis and treatment of Helicobacter pylori infection. Its relationship with gastrointestinal ulcer and antimicrobial resistance]. / Diagnóstico y tratamiento de la infección por Helicobacter pylori. Su relación con la úlcera gastrointestinal y la resistencia a los antimicrobianos.

Reliable data regarding the efficacy of different schemes of triple therapy for the eradication of Helicobacter pylori in our country, are not available. Patients with Helicobacter pylori infection and non-ulcer dyspepsia or active peptic ulcer disease were randomized in three different groups for therapy with, omeprazole 20 mg, clarithromycin 500 mg and amoxicillin 1000 mg, twice daily for one week (OCA 1, 40 patients) and the same treatment but for two weeks in a second group (OCA 2, 40 patients). The third group received omeprazole 20 mg, clarithromycin 500 mg and metronidazole 500 mg twice daily during one week (OCM, 40 patients). The primary efficacy end point was the eradication of Helicobacter pylori as confirmed by negative urea breath test, 4 weeks after the completion of treatment. Of 120 patients enrolled in the study, 113 met the entry criteria. Of them, 103 completed the treatment. When analyzed by intention to treat, after 4 weeks of finishing the treatment, Helicobacter pylori was eradicated in 92.3% of patients in OCA 1, 89.7% in OCA 2, and 82.8% in OCM. There was no significant difference between the three groups, regarding the eradication efficacy. Side effects were observed more frequently in OCA 2 and OCM groups. Primary resistance to amoxicillin and clarithromycin was not demonstrated, while 20% of cultured strains were resistant to metronidazole. In patients with peptic ulcer disease or non-ulcer dysplasia, triple therapy with omeprazole and two antibiotics is highly effective in the eradication of Helicobacter pylori. One week of OCA therapy is as effective as two weeks of OCA or one week of OCM, with less side effects.