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Journal of Clinical Microbiology, October 1999, p. 3328-3331, Vol. 37, No. 10
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Detection of Helicobacter pylori Antibodies in a Pediatric Population: Comparison of Three Commercially Available Serological Tests and One In-House Enzyme Immunoassay

Bengt Sunnerstam,1,* Torbjörn Kjerstadius,2 Lillemor Jansson,2 Johan Giesecke,3 Mats Bergström,4 and Jan Ejderhamn5

Department of Pediatrics1 and Department of Clinical Microbiology,2 Central Hospital, Karlstad, and Department of Epidemiology, Swedish Institute for Infectious Disease Control,3 and Department of Clinical Chemistry4 and Department of Pediatrics,5 Huddinge Hospital, Stockholm, Sweden

Received 4 February 1999/Returned for modification 23 March 1999/Accepted 14 June 1999

A serum immunoglobulin G enzyme immunoassay (EIA) for Helicobacter pylori antibodies already in use in adults was evaluated with 99 pediatric serum samples to determine its usefulness for the study of H. pylori disease in children. The reference method used was either the 13C-urea breath test or a biopsy culture of gastric mucosa. In children, an EIA cutoff of 0.35 absorbancy unit yielded sensitivity, specificity, and positive and negative predictive values of 93, 97, 93, and 97%, respectively. The cutoff recommended when this EIA was published for use in adults was 0.70 absorbancy unit (H. Gnarpe, P. Unge, C. Blomqvist, and S. Mäkitalo, APMIS 96:128-132, 1988). Another subset of 169 serum samples taken from children was analyzed by four serological tests in order to compare the performance of the in-house EIA with the Pyloriset, HM-CAP, and Helico-G kits. For the 169 samples, 10 (5.9%) false-positives and no false-negatives occurred with the Helico-G, 3 (1.8%) false-positives and no false-negatives occurred with the Pyloriset, and 3 (1.8%) false-positives and 1 (0.6%) false-negative occurred with the HM-CAP. For the 169 samples, 1 (0.6%) false-positive and no false-negatives occurred with the in-house EIA. Serological detection of H. pylori antibodies with our EIA seems to be valuable in diagnosing H. pylori infection in children, but only if a lowered, specific pediatric cutoff is established. The commercial kits, particularly the Helico-G, seem to overdiagnose pediatric H. pylori infection. A positive serological test for H. pylori infection, particularly for children, needs to be confirmed by a reference method because of the possibility of spontaneous eradication of infection, with a lingering serological response.

* Corresponding author. Present address: Department of Pediatrics, Örebro Medical Centre Hospital, S-701 85 Örebro, Sweden. Phone: 46 19 15 10 00. Fax: 46 19 18 79 15. E-mail: Bengt.Sunnerstam{at}telia.com.

Journal of Clinical Microbiology, October 1999, p. 3328-3331, Vol. 37, No. 10
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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