This clinical update outlines a change in approach to laboratory testing of H. pylori infection in children.
Currently a significant proportion of H. pylori faecal antigen requests received by Pathlab come from children under 16 years, however local and international guidelines for children (references given below) recommend that investigation and subsequent treatment for H. pylori should be limited to patients with a high level of suspicion of peptic ulcer disease and should be diagnosed endoscopically. Screening children with non-invasive markers of H. pylori, including stool antigen test, is NOT recommended, other than to document successful eradication.
In line with these recommendations, please note that effective 5th October 2020, faecal antigen testing for H. pylori in persons under 16 years will be restricted to those requests where specialist approval has been gained from a Paediatrician or Gastroenterologist.
This policy is already in place or being considered for implementation in several other diagnostic laboratories within New Zealand.
Please contact us if you have any questions with regards to the above on ClinicalMicrobiology@pathlab.co.nz
References:
https://www.starship.org.nz/guidelines/helicobacter-pylori-h-pylori-infection/
https://journals.lww.com/jpgn/Fulltext/2017/06000/Joint_ESPGHAN_NASPGHAN_Guidelines_for_the.33.aspx