13C-Urea Breath Test to Diagnose Helicobacter pylori Infection in Children Aged up to 6 Years


Reprint requests to: Rodrigo Strehl Machado, 1596 Loefgreen Street, São Paulo, Brazil.


Background. 13C-urea breath test (13C-UBT) is an accurate noninvasive tool for diagnosis of Helicobacter pylori infection. It is considered the best method for epidemiological studies, but there are few studies to evaluate the 13C-UBT in infants and toddlers.

Aim.  To evaluate the 13C-UBT performed with infrared spectroscopy in children aged up to 6 years.

Patients.  Sixty-eight patients (6 months. to 5 years 11 months.) were evaluated prospectively and consecutively.

Methods. Helicobacter pylori infection was detected by positive culture, or rapid urease test and histological examination, both positive. 13C-UBT was performed with 50 mg of 13C-urea diluted in 100 ml of commercial orange juice. Two expired air samples were collected: before and 30 minutes after tracer ingestion. Cutoff of delta over baseline (DOB) was 4.0‰ and urea hydrolysis rate 10 µg/minute.

Results.  Fifteen of 68 (22.1%) patients were H. pylori infected. Sensitivity was 93.3% (95% CI; 86.8%–99.7%) and specificity was 96.2% (95% CI; 93.6%–98.8%), and these values were equal for DOB and urea hydrolysis rate. Negative DOB values in noninfected patients ranged from −1.5‰ to 2.6‰ and positive DOB values ranged from 10.8‰ to 105.5‰. There was no relationship between DOB values and age.

Conclusion. 13C-UBT performed with infrared spectroscopy proved to be a reliable and accurate noninvasive diagnostic tool for H. pylori infection detection in children aged up to 6 years. Results far from cutoff value can clearly distinguish positive from negative 13C-UBT results in children up to 6 years old.