Comparison of Stool Antigen and PCR-Based Diagnostics for Helicobacter pylori Infection and Associated Gut Dysbiosis in Wad-Medani City, Sudan

Abstract

Background: The development of stomach illnesses has been linked, in part, to Helicobacter pylori (H. pylori) infection; in clinical practice, accurate identification of Helicobacter pylori infection is crucial, H. pylori infection was associated with a decrease in microbial diversity and an increase in pathogenic taxa, indicating its role in gut dysbiosis. Objectives: We tested a noninvasive method using immunochromatography to detect the presence of the H. pylori antigen in stool specimens. PCR was used to validate the presence of H. pylori by identifying the bacteria's ureC gene in the DNA extracted from stool specimens. Additionally, gut microbiome changes were assessed, understanding the link between H. pylori infection and gut dysbiosis is vital for public health interventions. Method: A total of 100 stool samples obtained from dyspeptic patients (46 men and 54 women, average age 46.1) were assessed using these methods. The results were then compared between the PCR-based technique and the SAT technique. Results: The results showed that 35 (35%) out of 100 samples were positive by the PCR-based technique, compared to 33 (33%) positive by the SAT technique and The PCR method demonstrated a sensitivity of 95% and specificity of 92% in detecting H. pylori. Beta diversity was assessed using Bray-Curtis dissimilarity, revealing significant variations in microbial composition among samples. Conclusion: These data suggest that the techniques used in this study are valuable for studying the molecular epidemiology of H. pylori infection in dyspeptic patients. Stool, as a non-invasive sample, has the potential to be a good replacement for the detection of H. pylori. Additionally, we found that infection with this bacterium contributes to gastric microbial dysbiosis,  while no statistically significant differences were observed.