Skip to main content
Log in

Comparison of the Clinical Feasibility of Three Rapid Urease Tests in the Diagnosis of Helicobacter pylori Infection

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Rapid urease tests (RUTs) are a fast, accurate, and inexpensive method to diagnose H. pylori infection in the endoscopy suite. Of these, the CLO test is both common and widely used. The aim of our study was to evaluate the accuracy and positive reaction times of two new rapid urease tests (ProntoDry and HpONE) in comparison with the CLO test. Fifty-one patients (26 men, 25 women; mean age, 52.4 years) were included in this study, and all underwent esophagogastroduodenoscopy (EGD). None of the patients had received any prior H. pylori eradication therapy. H. pylori infection status was evaluated by histology, culture, 13C–UBT, and RUT. H. pylori infection was considered to be positive if the culture was positive or if two of the other three tests (histology, RUT, and 13C–UBT) were positive. If culture was negative and only one of the other three tests was positive, or if all four tests were negative, the result was interpreted as negative. Of these 51 patients, 2 were excluded and 29 (59.1%) were infected with H. pylori. The sensitivities, specificities, positive predictive values, and negative predictive values of the three RUTs were not significantly different. The mean positive reaction times of the three RUTs (CLO test, ProntoDry, and HpONE) were 67.8 ± 12.0, 16.5 ± 2.2, and 17.8 ± 2.1 min, respectively. ProntoDry (P < 0.001) and HpONE (P < 0.001) had significantly faster reaction times than the CLO test, but there was no significant difference between ProntoDry and HpONE. Different media of RUTs may influence the rapidity of a positive reaction time. Both ProntoDry and HpONE were superior to the CLO test in terms of accuracy, reaction time, and cost-effectiveness.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Marshall BJ, Warren JR: Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 1:1311–1315, 1984

    Article  Google Scholar 

  2. Trevisani L, Sartori S, Ruina M, Caselli M, Rossi MR, Costa F, Bellini M, Iaquinto G, Gardullo N, Todisco A: Helicobacter pylori stool antigen test: clinical evaluation and cost analysis of a new enzyme immunoassay. Dig Dis Sci 44:2303–2306, 1999

    Google Scholar 

  3. Konstantopoulos N, Russmann H, Tasch C, Sauerwald T, Demmelmair H, Autenrieth I, Koletzko S: Evaluation of the Helicobacter pylori stool antigen test (HpSA) for detection of Helicobacter pylori infection in children. Am J Gastroenterol 96:677–683, 2001

    Google Scholar 

  4. Coombs GW, Foster NM, Pearman JW, Forbes GM: Detection of Helicobacter pylori antigen in faeces by enzyme immunoassay. Pathology 33:496–497, 2001

    Google Scholar 

  5. Forne M, Dominguez J, Fernandez-Banares F, Lite J, Esteve M, Gali N, Espinos JC, Quintana S, Viver JM: Accuracy of an enzyme immunoassay for the detection of Helicobacter pylori in stool specimens in the diagnosis of infection and posttreatment check-up. Am J Gastroenterol 95:2200–2205, 2000

    Google Scholar 

  6. Metz DC: Stool testing for Helicobacter pylori infection: yet another noninvasive alternative. Am J Gastroenterol 95:546–548, 2000

    Google Scholar 

  7. Malfertheiner P, Megraud F, O’Morain C, Hungin AP, Jones R, Axon A, Graham DY, Tytgat G: Current concepts in the management of Helicobacter pylori infection—The Maastricht 2-2000 Consensus Report. Aliment Pharmacol Ther 16:167–180, 2002

    Article  CAS  Google Scholar 

  8. Wang WM, Lee SC, Ding HJ, Jan CM, Chen LT, Wu DC, Liu CS, Peng CF, Chen YW, Huang YF, Chen CY: Quantification of Helicobacter pylori infection: Simple and rapid 13C-urea breath test in Taiwan. J Gastroenterol 33:330–335, 1998

    Google Scholar 

  9. Graham DY, Lew GM, Malaty HM, Evans DG, Evans DJ Jr, Klein PD, Alpert LC, Genta RM: Factors influencing the eradication of Helicobacter pylori with triple therapy. Gastroenterology 102:493–496, 1992

    Google Scholar 

  10. Laheij RJ, de Boer WA, Jansen JB, van Lier HJ, Sneeberger PM, Verbeek AL: Diagnostic performance of biopsy-based methods for determination of Helicobacter pylori infection without a reference standard. J Clin Epidemiol 53:742–746, 2000

    Google Scholar 

  11. Laine L, Lewin D, Naritoku W, Estrada R, Cohen H: Prospective comparison of commercially available rapid urease tests for the diagnosis of Helicobacter pylori. Gastrointest Endosc 44:523–526, 1996

    Google Scholar 

  12. Marshall BJ, Warren JR, Francis GJ, Langton SR, Goodwin CS, Blincow ED: Rapid urease test in the management of Campylobacter pyloridis-associated gastritis. Am J Gastroenterol 82:200–210, 1987

    Google Scholar 

  13. Lee N, Lee TT, Fang KM: Assessment of four rapid urease test systems for detection of Helicobacter pylori in gastric biopsy specimens. Diagn Microbiol Infect Dis 18:69–74, 1994

    Google Scholar 

  14. Ng FH, Wong SY, Ng WF: Storage temperature of the unbuffered rapid urease test. Am J Gastroenterol 92:2230–2231, 1997

    Google Scholar 

  15. Laine L, Estrada R, Lewin DN, Cohen H: The influence of warming on rapid urease test results: a prospective evaluation. Gastrointest Endosc 44:429–432, 1996

    Google Scholar 

  16. Laine L, Chun D, Stein C, El-Beblawi I, Sharma V, Chandrasoma P: The influence of size or number of biopsies on rapid urease test results: a prospective evaluation. Gastrointest Endosc 43:49–53, 1996

    Google Scholar 

  17. el-Zimaity HM, al-Assi MT, Genta RM, Graham DY: Confirmation of successful therapy of Helicobacter pylori infection: number and site of biopsies or a rapid urease test. Am J Gastroenterol 90:1962–1964, 1995

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Deng-Chyang Wu MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tseng, CA., Wang, WM. & Wu, DC. Comparison of the Clinical Feasibility of Three Rapid Urease Tests in the Diagnosis of Helicobacter pylori Infection. Dig Dis Sci 50, 449–452 (2005). https://doi.org/10.1007/s10620-005-2456-5

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-005-2456-5

Keywords:

Navigation