H. pylori Breath Test, Pediatric

Label Mnemonic:	UBTPED
Epic code:	LAB8127
Downtime form:	A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery

Commercial Mailout Laboratory
6240-8 RCP
356-8593

Specimen(s):

Breath

Specimen Instructions:

Specimen Preparation:
1) Label breath collection bags with patient name, MRN, date and
   time of collection, and indicate Pre (blue) or Post (pink).
2) Collect the baseline (Pre) breath specimen according to the
   instructions in the BreathTek UBT kit.
3) After the allotted time, collect the Post breath specimen according
   according to the instructions in the kit.

Information required: Record weight, height, gender, and 
age.

For a valid result, the post breath specimen must be collected between 
15 and 30 minutes after the patient drinks the Pranactin-Citric 
solution.

Collection Medium:

H. pylori Breath Test Kit

Rejection Criteria:

Underinflated bags. Specimens from patients younger than 3 years.

Delivery Instructions:

Critical room temperature. Do not refrigerate or freeze.

Turn Around Time:

1-4 days upon receipt at reference laboratory

Reference Range:

Negative

Interpretive Data:

A negative result does not rule out the possibility of H. pylori infection. If clinical signs are suggestive of H. pylori infection, retest with a new specimen or an alternate method. Known causes of false-negative results include:

1. Use of antibiotics, proton pump inhibitors, and bismuth
   preparations during the preceding 2 weeks. 
2. Administration of the breath test less than 4 weeks after completion
   of definitive therapy to eradicate H. pylori.
3. Premature or late collection of the post-dose specimen.

Known causes of false-positive results include:
1. Patients with achlorhydria.
2. Rinsing the testing solution in the mouth, which can allow contact
   with urease-positive bacteria.
3. The presence of other gastric spiral organisms such as 
   Helicobacter heilmanii.

Note: The post-dose sample must be collected between 15 and 30 minutes 
post-dose to prevent a false- negative result.

Comments:

Order this test to diagnose H. pylori infection in children and adolescents (3 to 17 years of age).

Testing kits are available from Specimen Control, 6240 RCP.

Patient preparation:
This test requires the pediatric patient (3-17 years old) to fast and abstain from smoking for 1 hour prior to test administration. The patient should not have taken antibiotics, proton pump inhibitors (e.g., Prilosec, Prevacid, Aciphex, Nexium), or bismuth preparations (e.g., Pepto-Bismol) within the previous 14 days. The effect of histamine 2-receptor antogonists (e.g., Axid, Pepcid, Tagamet, Zantac) may reduce urease activity on urea breath tests and should be discontinued for 24-48 hours before the sample is collected. When used to monitor treatment, the test should be performed four weeks after cessation of definitive therapy. The patient should be informed that the Pranactin-Citric drink that will be administered contains phenylalanine. Phenylketonurics restrict dietary phenylalanine.

For a valid result, the post breath specimen must be collected 15 to 30 minutes after the patient drinks the Pranactin-Citric solution.

Return kit to Specimen Control, 6240 RCP.

Sample stability: 1 week only-must reach reference laboratory within a week of collection. Critical ambient.

Methodology:

Qualitative Spectrophotometry

CPT Code:

83013