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Open Access Highly Accessed Research article

Evaluation of a new fluorescence quantitative PCR test for diagnosing Helicobacter pylori infection in children

Zhiying Ou1, Liya Xiong1, Ding-You Li2*, Lanlan Geng1, Lixia Li1, Peiyu Chen1, Min Yang1, Yongmei Zeng1, Zhenwen Zhou1, Huimin Xia1 and Sitang Gong1*

Author Affiliations

1 Department of Gastroenterology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical College, 9 Jinsui Road, Guangzhou, 510623, China

2 Department of Pediatrics, University of Missouri Kansas City School of Medicine, Division of Gastroenterology, Children’s Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA

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BMC Gastroenterology 2013, 13:7  doi:10.1186/1471-230X-13-7

Published: 14 January 2013

Abstract

Background

Numerous diagnostic tests are available to detect Helicobactor pylori (H. pylori). There has been no single test available to detect H. pylori infection reliably. We evaluated the accuracy of a new fluorescence quantitative PCR (fqPCR) for H. pylori detection in children.

Methods

Gastric biopsy specimens from 138 children with gastritis were sent for routine histology exam, rapid urease test (RUT) and fqPCR. 13C-urea breath test (13C-UBT) was carried out prior to endoscopic procedure. Gastric fluids and dental plaques were also collected for fqPCR analysis.

Results

38 children (27.5%) were considered positive for H. pylori infection by gold standard (concordant positive results on 2 or more tests). The remaining 100 children (72.5%) were considered negative for H. pylori. Gastric mucosa fqPCR not only detected all 38 H. pylori positive patients but also detected 8 (8%) of the 100 gold standard-negative children or 11 (10.7%) of the 103 routine histology-negative samples. Therefore, gastric mucosa fqPCR identified 46 children (33.3%) with H. pylori infection, significantly higher than gold standard or routine histology (P<0.01). Both gastric fluid and dental plaque fqPCR only detected 32 (23.2%) and 30 (21.7%) children with H. pylori infection respectively and was significantly less sensitive than mucosa fqPCR (P<0.05) but was as sensitive as non-invasive UBT.

Conclusions

Gastric mucosa fqPCR was more sensitive than routine histology, RUT, 13C-UBT alone or in combination to detect H. pylori infection in children with chronic gastritis. Either gastric fluid or dental plaque PCR is as reliable as 13C-UBT for H. pylori detection.

Keywords:
Fluorescence quantitative PCR; Helicobacter pylori; Gastric mucosa; Gastric fluids; Dental plaques; Children