The effectiveness of ultrafast urease tests in the diagnostics of Helicobacter pylori-associated gastritis in children

BACKGROUND: Helicobacter pylori is one of the main causes of gastritis, peptic ulcer and stomach cancer. Ultrafast urease tests (UUT) simplify patient’s management by obtaining results in 5 minutes and including them into the protocol of endoscopic examination. There is no information on UUT accuracy in pediatric population.

AIM: To identify UUT accuracy while comparing it with histological testings in children.

METHODS: a single-center retrospective trial included 4–18 y.o. children who underwent esophagogastroduodenoscopy with biopsy of the gastric antrum mucosa for H. pylori UUT, followed by the histological testing. The researchers assessed the time for positive reaction which had been announced by manufactures as not more than 5 min. Histology was the "gold standard".

RESULTS: 211 patients 4–18 years old were examined (boys 103, 48.8%; girls 108, 51.2%) average age (11.7±3.5) years. H. pylori infection was detected in 31 out of 211 patients. There was a significantly higher number of positive reactions of both UUT’s in the age group of children from 11 to 18 years old compared with the group of children from 4 to 10 years old. The sensitivity of AMA RUT Pro UUT was 18.7%, specificity — 93.8%, negative and positive predictive value — 82 and 42%, respectively, accuracy — 79%. The sensitivity of the BioHit UFT300 UFUT was 40%, specificity — 96.5%, negative and positive predictive value — 92 and 60%, respectively, accuracy — 90%.

CONCLUSION: Our findings have demonstrated low sensitivity of ultrafast urease tests in children when using only a single fragment of tissue from the gastric antrum for the negative result during five-minute reaction time announced by the manufacturer. Maybe, the sensitivity level can be improved by placing several fragments from the mucous membrane of stomach body and antrum for one test. The authors suggest this direction as a possible future research.