How (who ?) and when to test or retest for H. pylori.
Several direct/invasive and indirect/non-invasive diagnostic tests are available for the diagnosis of H. pylori infection.
Invasive tests require biopsy sampling of the gastric mucosa and include rapid urease test, histology, bacterial culture and polymerase chain reaction technique.
Non-invasive tests include the urea breath test and serological assays.
This review gives a critical comparative analysis of accuracy, advantages and limitations of the different diagnostic tests including current cost and availability in Belgium.
Rapid urease testing (RUT) of gastric biopsy specimens is probably the initial test of choice in patients undergoing endoscopy because of its low cost, rapid availability of results, simplicity and accuracy.
Histological examination of gastric biopsy samples should be mandatory at the initial presentation of the patient because it also gives insight on the status of the gastric mucosa (inflammation & premalignant changes).
Although not mandatory for primary diagnosis, a biopsy for culture and sensitivity testing should always be obtained when it is available and when endoscopy is undertaken as part of the patient's management.
Among the non-invasive tests, the place of serology remains questionable for other than epidemiological purposes.
How is H. pylori infection best diagnosed ?
How many tests are needed in routine clinical practice ?
The answer will depends on the clinical setting and local availability of the tests. (...)
Mots-clés Pascal : Gastrite, Bactériose, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Traitement, Surveillance, Réinfection, Technique, Symptomatologie, Exploration microbiologique, Histopathologie, Indication, Article synthèse, Homme, Appareil digestif pathologie, Estomac pathologie, Anatomopathologie
Mots-clés Pascal anglais : Gastritis, Bacteriosis, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Treatment, Surveillance, Reinfection, Technique, Symptomatology, Microbiological investigation, Histopathology, Indication, Review, Human, Digestive diseases, Gastric disease, Pathology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0470509
Code Inist : 002B30A01C. Création : 19/02/1999.