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Use of the Noninvasive Entero-test in the Detection of Helicobacter pylori in Children in an Endemic Area in Colombia

Arboleda, Richard N.*; Schneider, Barbara G.*; Bravo, Luis E.; Romero-Gallo, Judith*; Peek, Richard M. Jr*; Mera, Robertino M.*; Yepez, Maria Clara; Campo, Cristina; Correa, Pelayo*

Journal of Pediatric Gastroenterology and Nutrition: August 2013 - Volume 57 - Issue 2 - p 192–196
doi: 10.1097/MPG.0b013e318293e1e1
Original Articles: Gastroenterology

Background and Objective: Gastric infection with Helicobacter pylori (H pylori), a strong risk factor for gastric cancer, is highly prevalent in children residing in the Colombian Andes. We aimed to validate the use of the Entero-test to culture and genotype H pylori strains from asymptomatic Colombian children.

Methods: Children (ages 10–15 years, n = 110, 80 of which were H pylori positive by the urea breath test [UBT]) were subjected to the Entero-test, and strings were cultured and/or used for DNA extraction for polymerase chain reaction (PCR). These children had been treated for H pylori in 2007. A second population of children (ages 10–15 years, n = 95),which had not been previously treated, was also subjected to the Entero-test.

Results: Of UBT-positive children in the treated group, 29 of 80 (36%) Entero-test samples were H pylori culture positive; 29 additional string extracts were tested by PCR for the H pylori virulence factors cagA and vacA. PCR from cultures and extracts yielded a sensitivity of 74% and specificity of 87%. In the untreated group, 16 of 94 UBT-positive children (17%) produced Entero-tests that were culture positive. Fifty-eight of 94 (62%) string extracts were PCR positive for cagA and/or vacA. In previously treated children, H pylori strains were more often the less virulent vacA s2 (P = 0.001), m2 (P = 0.006), and i2 genotypes (P = 0.039).

Conclusions: The Entero-test may be used as a noninvasive test to detect H pylori in asymptomatic children residing in high-risk areas for gastric cancer. Treatment of H pylori in children was associated with less virulent genotypes.

*Department of Medicine, Division of Gastroenterology, Vanderbilt University School of Medicine, Nashville, TN

Department of Pathology, Universidad del Valle School of Medicine, Cali

Universidad de Nariño, Pasto, Colombia.

Address correspondence and reprint requests to Barbara G. Schneider, PhD, Department of Medicine, Vanderbilt University Medical Center, 2215 Garland Ave, Room 1030C MRB4, Nashville, TN 37232 (e-mail:

Received 13 July, 2012

Accepted 22 March, 2013

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The authors report no conflicts of interest.

© 2013 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,