Trevisani L et al. (2005) Evaluation of a new rapid immunoassay for the detection of Helicobacter pylori in faeces: a prospective pilot study. Aliment Pharmacol Ther 21: 485–489

A range of noninvasive tests promise to replace endoscopy in the diagnosis of H. pylori infection. Some of these are based on the detection of H. pylori antigens in stool samples, and one such test has recently been evaluated in a pilot study by Trevisani et al.

The ImmunoCard STAT kit (Meridian Bioscience Inc., Cincinnati, OH) is an immunochromatographic assay designed to detect H. pylori in four drops of diluted stool sample. This test kit was compared with a laboratory-based method, namely the Hp StAR kit (Amplified IDEIA Hp StAR, DakoCytomation Ltd, Ely, UK), in 105 patients undergoing endoscopic assessment for H. pylori status.

Results from brush cytology, histologic examination of biopsy material and the rapid urease test were together used as the gold-standard method for determining H. pylori status. Two or three positive results indicated positive status, three negative results indicated negative status, and one positive result indicated 'indeterminate' status. Comparison of the ImmunoCard STAT results with the gold-standard results showed a sensitivity and specificity of 85% and 93%, respectively. The corresponding values for the laboratory-based Hp StAR kit were similar, at 88% and 100%.

Trevisani and colleagues conclude, therefore, that the ImmunoCard STAT kit “seems a reliable method for detecting H. pylori in untreated patients”. This method might replace the more time-consuming laboratory-based tests.