The CLO test in the UK: inappropriate reading and missed results.
ABSTRACT In endoscopy units, the CLO test is frequently used to detect Helicobacter pylori (H. pylori). Informal survey suggested that practice deviated from that recommended, with little account taken of possible confounders such as acid-suppressing medication.
To determine the influence of reading time and acid suppression on CLO tests and to estimate impact on test results in UK endoscopy units.
Survey of use of CLO tests. Prospective study of time to positivity and concurrent medication in CLO tests from 782 patients.
Forty-eight endoscopy units throughout the UK, and a district hospital endoscopy unit.
Eighteen endoscopy units in the old Northern Region, and a random sample of 30 other UK units.
Time of reading of CLO tests in UK units, and time to positivity of CLO tests in one hospital.
Endoscopy units most frequently used CLO tests to assess H. pylori colonization, with marked differences in the times when tests were read. Nineteen out of 37 units discarded tests considerably earlier than the recommended 24 h. Over 20% of CLO tests became positive more than 2 h after collection, with 11% taking 24 h to change colour. Acid-suppressing medication prolonged time to positivity.
The majority of endoscopy units read tests earlier than recommended. Acid-suppressing medication delays the development of CLO tests and may increase numbers of false-negative tests. Endoscopy units should read tests at 24 h and preferably test patients off ulcer healing medication.
Article: Prevalence and risk factors for Helicobacter pylori infection among Yemeni dyspeptic patients.[show abstract] [hide abstract]
ABSTRACT: Helicobacter pylori (H. pylori) is one of the world's most common human bacterial infections. Acquisition of H. pylori infection may be associated with chronic gastritis, peptic ulceration and gastric cancer. This study was aimed at investigating the prevalence of H. pylori infection among dyspeptic patients, any correlation with dyspeptic symptoms and endoscopic findings and, any socioeconomic and environmental risk factors. The study was conducted between September 1997 and October 1998 in one Endoscopy Unit, Sana'a city, Yemen. A total of 275 consecutive patients with chronic dyspepsia were enrolled in the study. Endoscopic examination was conducted, gastric biopsies were obtained from the antrum and corpus, and H. pylori infection was diagnosed at the time of endoscopy using the rapid urease test. The prevalence of H. pylori infection in our patients was 82.2% (95% confidence interval (CI) 78 to 87%). Independent variables associated with infection were age >40 years (odds ration (OR)=2.2; 95% CI: 1.0-4.64; P=0.043); the presence of >or= 5 children under 14 years per household (OR=6.62; 95% CI: 2.245 to 19.5; P= 0.001); and duodenal ulcer disease (OR=3.7; 95% CI: 1.38 to 10.0; P=0.009). The prevalence of H. pylori infection in dyspeptic patients in Yemen seems to be high. Advancing age, 5 or more children per household and duodenal ulcer disease were found to be significantly associated with H. pylori infection.Saudi medical journal 06/2003; 24(5):512-7. · 0.52 Impact Factor