Comparison of the Diagnostic Accuracy of Five Different Stool Antigen Tests for the Diagnosis of Helicobacter pylori Infection

Abstract Background Several noninvasive diagnostic tests based on the detection of H elicobacter pylori stool antigen ( H p SA ) have been developed. The aim of the study was to compare the diagnostic accuracy of 5 Hp SA tests—2 monoclonal enzyme immunoassay tests ( EIA s: the Premier Platinum Hp SA P lus test and H elicobacter pylori A ntigen ( H p A g) test) and 3 rapid immunochromatographic assay ( ICA ) tests (the I mmunoCard STAT ! H p SA test, one step H p SA test , and H . pylori fecal antigen test)—for diagnosing H . pylori infection in adult patients with dyspeptic symptoms before eradication therapy. Materials and Methods A total of 198 patients with dyspeptic symptoms were included in the study. A gastric biopsy was collected for histopathology and rapid urease testing. Stool specimens for Hp SA testing were also collected. Patients were considered H . pylori positive if two invasive tests (histological and rapid urease tests) were positive. Results The sensitivity and specificity were 92.2% and 94.4%, respectively, for the P remier P latinum Hp SA Plus test; 48.9% and 88.9%, respectively, for the HP A g test; 86.7% and 88.9, respectively, for the O ne S tep H p SA test; 68.9% and 92.6%, respectively, for the ImmunoCard STAT ! H p SA test; and 78.9% and 87%, respectively, for the H . Pylori fecal antigen test. Conclusions The Premier Platinum Hp SA Plus EIA test was determined to be the most accurate stool test for diagnosing H . pylori infections in adult dyspeptic patients. The currently available ICA ‐based tests are fast and easy to use but provide less reliable results.