Usefulness of Gastric Biopsy-Based Real-Time Polymerase Chain Reaction for the Diagnosis of Helicobacter pylori Infection in Children
Usefulness of Gastric Biopsy-Based Real-Time Polymerase Chain Reaction for the Diagnosis of Helicobacter pylori Infection in Children
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DOI：
10.1097/mpg.0000000000000787
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发表时间：
2015-09-01
影响因子：
2.9
通讯作者：
Raymond, Josette
中科院分区：
文献类型：
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作者：
Kalach, Nicolas;Gosset, Pierre;Raymond, Josette
目的：本研究的目的是评估基于胃活检的定量实时聚合酶链反应（qPCR）在儿童幽门螺杆菌感染检测和克拉霉素耐药菌株鉴定中的有效性。方法：在 62 名感染儿童和 341 名未感染儿童中评估基于胃活检的 qPCR 检测儿童幽门螺杆菌感染和鉴定儿童克拉霉素耐药菌株。当组织学和快速尿素酶试验（RUT）培养呈阳性时，参考方法考虑幽门螺杆菌感染。将结果与使用 qPCR 获得的结果进行比较。结果：参考方法与幽门螺杆菌 qPCR 阳性结果显示，置信区间灵敏度为 95%，敏感性为 100% 与 100%，特异性为 93.2% (86.9-99.4) 与 100%，阳性预测值 59.7% (47.4-71.9) 与 100%，阴性预测值 100% 与 100%，并且，最后，测试准确度为 59.6% (47.3-71.8) 而不是 100%。根据 qPCR 结果，发现 62 名儿童幽门螺杆菌呈阳性。其中，31名儿童qPCR和培养均呈阳性且药敏检测结果一致，而31名儿童培养阴性且qPCR阳性。当培养、组织学和 RUT 均呈阳性（29/31 名儿童）时，qPCR 显示细菌载量为每毫升 10(3) 个拷贝
Objectives: The aim of the study was to assess the usefulness of gastric biopsy-based quantitative real-time polymerase chain reaction (qPCR) for the detection of Helicobacter pylori infection and the identification of clarithromycin-resistant strains in children.Methods: A gastric biopsy-based qPCR for the detection of H pylori infection and the identification of clarithromycin-resistant strains in children was evaluated in 62 children with infection and 341 children without infection. H pylori infection was considered by the reference method when culture was positive for both histology and rapid urease test (RUT). Results were compared with those obtained using the qPCR.Results: The reference method versus H pylori qPCR positivity showed 95% confidence interval sensitivity 100% versus 100%, specificity 93.2% (86.9-99.4) versus 100%, positive predictive value 59.7% (47.4-71.9) versus 100%, negative predictive value 100% versus 100%, and, finally, test accuracy of 59.6% (47.3-71.8) versus 100%. Sixty-two children were found to be H pylori positive, based on the qPCR results. Among those, 31 children had both positive qPCR and culture with concordant antimicrobial susceptibility testing results, whereas 31 children had negative culture and positive qPCR. The qPCR showed a bacterial load 10(3) copies per milliliter when culture, histology, and RUT were all positive (29/31 children) versus