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Journal of Clinical Microbiology, October 2000, p. 3710-3714, Vol. 38, No. 10
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Two Enzyme Immunoassays and PCR for Detection of Helicobacter pylori in Stool Specimens from Pediatric Patients before and after Eradication Therapy

Athanasios Makristathis,1,* Wolfgang Barousch,1 Eva Pasching,1 Christa Binder,2 Christa Kuderna,3 Petra Apfalter,1 Manfred L. Rotter,1 and Alexander M. Hirschl1

Department of Clinical Microbiology, Hygiene Institute of the University of Vienna,1 St. Anna Pediatric Hospital,2 and Department of Pediatric Infectious Diseases, Wilhelminen Hospital,3 Vienna, Austria

Received 21 April 2000/Returned for modification 2 June 2000/Accepted 10 August 2000

This study of pediatric patients was intended to determine the suitability of stool PCR and two antigen enzyme immunoassays (EIAs; Premier Platinum HpSA and the novel FemtoLab H. pylori), which detect Helicobacter pylori antigens in feces, as pretreatment diagnostic tools and especially as posttreatment control. Forty-nine H. pylori-infected children with dyspepsia received eradication therapy. Successful treatment was determined by a negative [13C]urea breath test 4 and 12 weeks after discontinuation of therapy. Fecal specimens were collected prior to eradication therapy as well as 4 weeks after the end of treatment. Successfully treated children delivered stool samples at 6, 8, and 12 weeks posttreatment also. Specimens were examined by seminested PCR and Premier Platinum HpSA and were reexamined by both EIAs as soon as FemtoLab H. pylori was available. In the first test series, the overall sensitivities of PCR and Premier Platinum HpSA were 93.0 and 91.1%, respectively. With specimens collected at 4 weeks after treatment, the respective specificities were 68.8 and 79.3%. After longer follow-up periods, however, they gradually increased to 100 and 96.9%, respectively. In the new test series, Premier Platinum HpSA delivered a considerably lower number of false-positive results (4 versus 18), indicating intertest variations. The overall test sensitivity was 94.6%, and the overall specificity was 97.5%. FemtoLab H. pylori showed an excellent performance with an overall sensitivity and specificity of 98.2 and 98.1%, respectively. Thus, in contrast to PCR, both EIAs were shown to be suitable for early posttreatment control.

* Corresponding author. Mailing address: Department of Clinical Microbiology, University Hospital of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. Phone: 43 (1) 40400-5157. Fax: 43 (1) 40400-5162. E-mail: Athanasios.Makristathis{at}akh-wien.ac.at.

Journal of Clinical Microbiology, October 2000, p. 3710-3714, Vol. 38, No. 10
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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