Division of Microbiology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences; Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Microbiol Immunol. 2013 Nov;57(11):772-7. doi: 10.1111/1348-0421.12099.
Diagnosis of active Helicobacter pylori infection in intellectually disabled (ID) children is problematic because they are unable to cooperate with performance of invasive tests. In this study, the non-invasive methods of measuring serum IgG antibody concentrations and performing stool antigen tests were used to screen for H. pylori infection in ID children. Eighty-seven children with intellectual disabilities were studied. The amount of serum IgG antibody against H. pylori was measured by the ELISA method. Stool samples were examined using an amplified IDEIA HpStAR kit. To assess categorical variables, X(2) , Fisher's exact and Kappa tests were used. The stool antigen tests showed that 93.1% of the children had H. pylori antigen and the serology test that 85.1% of children were positive for H. pylori IgG antibodies. Agreement between results of H. pylori stool antigen (HpSA) testing and IgG antibody serology was 82.8%; however, according to the kappa measure of agreement this agreement is not statistically significant (value, 0.128; P = 0.19). Discordant results were observed for 15 children (17.2%): 11 (12.6%) who were positive on HpSA test but negative by serology and 4 (4.6%) who were IgG seropositive but had negative HpSA tests. This study showed a notably higher rate of H. pylori infection in ID children than has been reported by others for non-ID children from the same geographical area. The HpSA test is a valid method for primary screening for H. pylori infection in ID children; it detects the specific antigens shed during active infections and has less cross-reactivity than serological tests that detect antibodies. HpSA is a sensitive non-invasive method for detecting infection in ID children and may serve as an accurate alternative to serology.
诊断智障（ID）儿童的活动性幽门螺杆菌（H. pylori）感染存在问题，因为他们无法配合进行侵入性检测。在这项研究中，使用测量血清 IgG 抗体浓度和进行粪便抗原检测的非侵入性方法来筛查 ID 儿童的 H. pylori 感染。研究了 87 名智障儿童。通过 ELISA 法测量针对 H. pylori 的血清 IgG 抗体量。使用扩增 IDEIA HpStAR 试剂盒检查粪便样本。使用 X(2)、Fisher 确切检验和 Kappa 检验评估分类变量。粪便抗原检测显示，93.1%的儿童存在 H. pylori 抗原，血清学检测显示 85.1%的儿童 H. pylori IgG 抗体阳性。H. pylori 粪便抗原（HpSA）检测结果与 IgG 抗体血清学检测结果的一致性为 82.8%；然而，根据一致性的 Kappa 测量值，这种一致性没有统计学意义（值为 0.128；P=0.19）。15 名儿童（17.2%）的结果不一致：11 名（12.6%） HpSA 检测阳性但血清学检测阴性，4 名（4.6%） IgG 血清学阳性但 HpSA 检测阴性。这项研究显示，与来自同一地理区域的非 ID 儿童相比，智障儿童的 H. pylori 感染率明显更高。HpSA 检测是 ID 儿童中 H. pylori 感染的有效初筛方法；它检测到在活性感染期间释放的特异性抗原，比检测抗体的血清学检测的交叉反应性更小。HpSA 是一种用于检测 ID 儿童感染的敏感非侵入性方法，可能是血清学的准确替代方法。
