Comparison of jejunal aspirate culture and methane and hydrogen breath test in the diagnosis of small intestinal bacterial overgrowth,Irish Journal of Medical Science

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Comparison of jejunal aspirate culture and methane and hydrogen breath test in the diagnosis of small intestinal bacterial overgrowth
Irish Journal of Medical Science ( IF 1.7 ) Pub Date : 2023-09-19 , DOI: 10.1007/s11845-023-03527-y
Shuai Tang _{1,

2} , Jia Li ₃ , Jinxia Ma ₂ , Yi Li ₄ , Yuying Li ₅ , Jun Wan ₂ , Ru Zhang ₂

Affiliation

Background

Small intestinal bacterial overgrowth (SIBO) is still difficult to diagnose. Quantitative culture of small intestine aspirate is recommended to be the gold standard. The methane and hydrogen breath tests are easily repeatable, sufficiently sensitive and highly specific for SIBO diagnosis. Our goal is to contrast the diagnostic value of the breath tests with jejunal aspiration cultures.

Methods

40 adult outpatients (age < 60) were enrolled in our study. Randomly, within 2 days, both the methane and the hydrogen breath test and jejunal aspiration culture were performed on each patient and the results of both tests were evaluated and contrasted.

Results

The jejunal culture was positive (10⁵CFU / mL) in 14/40(35%) subjects, the lactulose breath test (LBT) was positive in 18/40 (45%) subjects, and the glucose breath test (GBT) was positive in 12/40 (30%). The GBT showed good agreement (κ = 0.659) and LBT showed poor agreement (κ = 0.588) with the jejunal aspirate culture. The sensitivity, specificity, positive and negative predictive values of LBT/GBT were 85.7/71.4%,76.9/92.3%, 66.6/83.3% and 90.9/85.7%, respectively.

Conclusions

35% of patients with suspected SIBO are identified using jejunal aspirate cultures. For the identification of SIBO, GBT is more specific than LBT, but has a lower sensitivity. In individuals with suspected SIBO, the breath test should be initially due to its good agreement with the jejunal aspirate culture.

中文翻译：

空肠抽吸培养与甲烷、氢气呼气试验诊断小肠细菌过度生长的比较

背景

小肠细菌过度生长（SIBO）仍然难以诊断。建议将小肠抽吸物定量培养作为金标准。甲烷和氢气呼气测试易于重复、足够灵敏且对于 SIBO 诊断具有高度特异性。我们的目标是将呼气测试与空肠抽吸培养的诊断价值进行对比。

方法

40 名成人门诊患者（年龄 < 60 岁）参与了我们的研究。 2天内随机对每位患者进行甲烷和氢气呼气试验以及空肠抽吸培养，并对两项试验的结果进行评估和对比。

结果

14/40（35%）受试者空肠培养呈阳性（10 ⁵ CFU/mL），18/40（45%）受试者乳果糖呼气试验（LBT）阳性，葡萄糖呼气试验（GBT）阳性12/40 (30%) 呈阳性。 GBT 与空肠抽吸培养物表现出良好的一致性（κ = 0.659），LBT 显示出较差的一致性（κ = 0.588）。 LBT/GBT的敏感性、特异性、阳性预测值和阴性预测值分别为85.7/71.4%、76.9/92.3%、66.6/83.3%和90.9/85.7%。