[Diagnosis of Helicobacter pylori infection in childhood with a novel immunoenzyme method (HpStAR) which detects antigens in feces using monoclonal antibodies ]. / Diagnostika infekce Helicobacter pylori v detském veku novou enzymoimunoanalytickou metodou stanovením antigenu ve stolici (HpStAR) pomocí monoklonálních protilátek.

BACKGROUND: Premier Platinum HpSA EIA is an enzyme immunoassay developed for diagnosis of H. pylori infection using polyclonal antibodies against H. pylori in human stool. A new H. pylori stool antigen test, based on monoclonal antibodies, has been developed. Our aim was to evaluate prospectively the accuracy of the novel antigen stool test (DAKO HpStAR) using monoclonal antibodies for detection of H. pylori infection in children. METHODS AND RESULTS: Total of 93 children undergoing upper gastrointestinal endoscopy were included in the study. Biopsy specimens were sampled from the gastric antrum and from the corpus. Patients were classified as H. pylori positive if histology and urease test were positive. All children provided a stool sample within 3 days after gastroscopy. IgG serology against H. pylori was also employed. HpStAR test was performed according to the manufacturers protocol. Results were read at 450/630 nm by spectrophotometry (cut-off point 0.150). Of the 93 children, 26 were H. pylori positive (13.1 +/- 3.2 yr), and 67 patients were H. pylori negative (12.8 +/- 4.7 yr). Only 2 children were misclassified (1 false negative, and 1 false positive). Sensitivity was 96.1%, specificity 98.5%, the positive and negative predicting values were 96.1% and 98.5%, respectively. Serology showed sensitivity 88.5%, specificity 70.2%; the positive and negative predicting values were 53.5% and 94% respectively. CONCLUSION: HpStAR test based on monoclonal antibodies can be considered an accurate, non-invasive, reliable method for the diagnosis of H. pylori infection in children.

[Accurate noninvasive diagnosis of Helicobacter pylori infection using antigen determination in the feces in the pediatric population]. / Presná neinvazivní diagnostika infekce Helicobacter pylori pomocí stanovení antigenu ve stolici v detské populaci.

BACKGROUND: H. pylori can cause several gastroduodenal diseases. Because H. pylori infection is usually acquired in childhood, accurate diagnosis of the infection in the pediatric population is important. Tests for the diagnosis of H. pylori infection can be divided into invasive and noninvasive. The aim of our study was to compare invasive tests (endoscopy, gastric mucosal biopsy, histology) and the noninvasive, newly developed stool antigen test to diagnose H. pylori infection. METHODS AND RESULTS: 91 children (40 boys, 51 girls, mean age 12.6 +/- 3.5 years) with dyspeptic symptoms were tested for H. pylori infection using endoscopy and gastric biopsy and a new antigen test in stool samples (immunoassay). Thirty-one of the children (34.1%) with dyspepsia were found positive for H. pylori according to histologic examination and rapid urease test. In 28 of the 31 patients, H. pylori stool antigen could be detected (sensitivity 90.3%). Of the 60 patients with negative direct histologic examination and rapid urease test, 60 were H. pylori--negative in stool antigen test (specificity 100%). Positive predictive value of stool antigen test is 100% and negative predictive value is 95.2%. CONCLUSIONS: The stool antigen test is highly sensitive and specific. It will be potentially very helpful in the diagnosis of H. pylori infection and can replace endoscopy for detection of H. pylori infection in children with comparable accuracy and reliability.

[A water-borne epidemic of tularemia in Chlumcany]. / Vodní epidemie tularémie v Chlumcanech.

During an epidemic of tularaemia in Chlumcany in December 2000 48 people, 36 adults, 12 children fell ill. In the patients the oroglandular form predominated which was diagnosed 46 times. None of the patients died. The vehicle of the infection was inadequately treated water which was used by the patients for the preparation of soda water and for washing. Using the polymerase chain reaction francisellae were detected in two water samples.