[Evaluation of enzyme-linked immunosorbent assay for the diagnosis of Helicobacter pylori infection in children and adolescents]

Abstract

Background: Helicobacter pylori infection is recognized as the most frequent cause of chronic gastritis in adults and children. The diagnosis is accomplished with invasive methods in fragments of endoscopic gastric biopsies and non-invasive methods. The enzyme-linked immunosorbent assay constitutes a simple, fast exam and of low cost with high sensibility in adult patients.

Aim: The purpose of this study was to evaluate the ELISA method for the infection diagnosis for Helicobacter pylori in children and adolescents using the Cobas Core II kit (Roche). Helicobacter pylori was positive when the rapid urease test and the histology were both positive or when the culture was positive and Helicobacter pylori negative when all the tests were negative.

Patients/methods: Eleven hundred patients were studied, their age ranged from 3 months and 16 years, (mean = 8y 7m +/-; 4.0; median = 9y 5m). Helicobacter pylori infection was diagnosed in 47.7% (53/111).

Result: Sensitivity was 83.0% and 86.0%; specificity was 70.6% and 71.0%, using the cutoff of 7 U/mL and 5 U/mL, respectively. When only the positive culture was used as gold standard and the cutoff of 5 U/mL, the sensitivity was 93.3%. In patients older than 10 years, the sensibility was 90.6% and 96.8%; specificity was 71.0% and 61.9%, with the cutoff of 7 U/mL and 5 U/mL, respectively.

Conclusion: ELISA method had good sensitivity in children older than 10 years, using the cutoff 5 U/mL, but the specificity was low.