E-Test sensitivity and specificity for determination of antimicrobial susceptibility in clinical isolation of Helicobacter pylori

Sensibilidad y especificidad de E-test para la determinación de susceptibilidad antimicrobiana en aislamientos clínicos de Helicobacter pylori

Published 2014-04-21

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E-Test sensitivity and specificity for determination of antimicrobial susceptibility in clinical isolation of Helicobacter pylori. (2014). NOVA, 6(10). https://revistas.unicolmayor.edu.co/index.php/nova/article/view/121
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Marcela Rey Arévalo et al.
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    Numerous methods have been developed to detect Helicobacter pylori resistance to antimicrobials. The agar dilution is the reference method recommended by the Clinical Laboratory Standards Institute. However, it is not an easy technique that could be implemented at the laboratory routine. It must have sufficient time for preparation and handling of many culture mediums with different antibiotic concentrations. For that reason, several techniques emerge as an alternative of analysis, including E-test: an agar diffusion method, which consists of a strip with an antibiotic concentration gradient, which by reading an ellipse inhibition allows knowing the minimum inhibitory concentrations (MICs). These studies’ operative characteristics were obtained by means of contingency tables. The analysis was done using the program RevMan 5®.   From a total of 68 analyzed references, 8 reached the inclusion criteria. E-test sensitivity and specificity were analyzed as overall summary measures. 87% of the articles showed 100% sensitivity, and 75% showed 100% specificity. The summary measured obtained for sensitivity was 99% (IC 95% 98 – 99%) and 98% specificity (IC95% 97 - 99%). Heterogeneity tests showed homogenous studies in sensitivity and specificity (p = 0.82) (p = 0.99). Funnel Plot graphics showed asymmetry. E-test sensitivity (99%) and specificity (98%) showed excellent agreement, especially for claritromicine; however, there is no significant statistical evidence to conclude that more that 90% of the selected literature reports values of E-test sensitivity and specificity higher than 90% when compared to Agar dilution.

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