The biopsy urease (CLOtest™) test is inadequate for diagnosis of Helicobacter pylori infection in the elderly

A. M. Abdalla, Z. Hanzely, G. I. Perez-Perez, M. J. Blaser, P. R. Holt, S. F. Moss, E. M. Sordbllo

Research output: Contribution to journalArticlepeer-review


Seroprevalence studies in US populations indicate H. pylori (HP) infection increases with age. The pattern of infection in New York City has not been described. To determine the prevalence of infection in this racially-mixed, inner city population, we performed a retrospective survey of biopsy urease tests (CLOtest™) from patients undergoing esophagogastroduodenoscopy from 1/1/96 to 4/30/97. Positive tests for urease activity are generally accepted as indicators of HP infection. Overall, CLOtest positivity in 552 patients (237 male) was 36%, (males 38%, females 34%), and was more common in Hispanics (45%) and blacks (38%), compared with whites (18%). In all racial groups, the peak was observed in middle age and fell in the elderly (age 20-33%;age 44-59,42%; age 60-79,35% ;age ≥ 80,26%). To determine the cause of this unexpected fall in CLOtest positivity with age,we compared the CLOtest to 3 other tests (histology, anti-HP IgG, anti-HP plus anti-Cag A IgG) in a subset of 59 patients (24 male) who had not received medications in the preceding 3 mos. This data shows that the CLOtest is less sensitive than scrology for the detection of HP infection in patients > 60 yrs. Our findings suggest that urease tests may not be adequate for diagnosis of HP infection in the elderly.

Original languageEnglish (US)
Pages (from-to)368
Number of pages1
JournalClinical Infectious Diseases
Issue number2
StatePublished - 1997
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases


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