Ureolytic based tests
13C-urea breath technique
UBT as a direct non-invasive test with diagnostic accuracy of >95% (sensitivity >95%, Specificity >95%) is easy to perform and based on urea hydrolysis achieving within gastric mucosal epithelial cells produces ammonia and CO2. In this test, when an individual with H.pylori infection ingests 13C-labled urea, H.pylori as a famous urease enzyme producer breaks down the urea and the labeled CO2 will be monitored within a short time. It takes 2h for collecting the breath samples of patients. Also, a single sample is collectable in 40 min by the help of hyamine as a CO2 trapping agent for exhaling into it. Finally, the percentage of radioactivity of each sample is calculated by a scintillation counter. 13C has a non-radioactive property; so, the test is safe for children and pregnant women. UBT is occurred in different manners such as meal-based 13C UBT, tablet-based 13C UBT and, 14C UBT. Recently, the tablet-based 13C UBT is recommended. Different reports confirm UBT as an accessible, accurate, safe and practical test (45, 48, 58-62).
Serum bicarbonate and Ammonia vapor tests
In addition to UBT, there are other ureolytic techniques including serum bicarbonate and ammonia vapor which have their special applications. In serum bicarbonate test, the measure of serum 13C-carbonate is evaluated. This test is reliable and suitable as post-treatment setting (46).
Ammonia vapor test is used for assessing the level of ammonia gas in the patient breath. This method is absolutely cost effective method (46, 63).
Serologic tests are divided into four formats including the Enzyme-Linked ImmunoSorbant Assay (ELISA), agglutinat...
... middle of paper ...
...ophylactic health care is the first choice in the field of infectious diseases. Rapid and accurate diagnostics are absolutely determinant factors to control and treat the infection in early stages.
There are various invasive and non-invasive diagnostic methods for detecting H.pylori infection.
Among non-invasive assays UBT and SAT (FAT) are first-line diagnostic approaches and the serologic tests have the low accuracy. However, the availability, cost and the condition of test performance may differ from place to place. Thus, to improve the diagnostic methods there is no choice rather than combination of two or more techniques with each other.
There are a number of pharmacotherapies which depending on the condition of infection. Preferably, triple therapy is an appropriate choice but in the presence of drug resistant strains, quadruple therapy is recommended.
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