Investigation of stool specimens for helicobacter pylori antigen

Microbiology

The detection of H. pylori stool antigen is intended to aid in the diagnosis of H. pylori infection. This can also be used to demonstrate loss of H. pylori following treatment, however it is recommended that this is done at least four weeks following completion of therapy.

H. pylori has been established as an etiologic agent in chronic gastritis and peptic ulcer disease, and has been associated with mucosa-associated lymphoid tissue lymphoma and gastric adenocarcinoma.

Sample Type:

1-2g of stool in an appropriate sterile leak proof container.

Temperature: 2-8°C up to 3 days or frozen immediately at ≤-20°C where processing or transport is delayed

Turnaround Time:

24 hours. 48 hours if sample received frozen.

*Excludes Sundays and Bank Holidays

Sample Stability:

3 days @ 2-8ºC. >3days at ≤-20°C

Instrument / Procedure:

Immunochromatographic – Meridian ImunoCard STAT HpSA

Units:
Reference Range:
Precautions:

PLEASE NOTE: Samples and accompanying relevant patient/ isolate data maybe referred for confirmatory or further laboratory testing to Reference laboratories. Relevant Public Health departments may also be notified IF a notifiable disease is identified under the Infectious Diseases (Amendment) Regulations 2020 (S.I. No. 53/2020).

Preparation of patient: Collect specimens before antimicrobial therapy where possible.

Precautions: Specimens should be transported to the laboratory in an airtight sterile container. Watery stool samples (composed mainly of fluid with little or no solid matter) are not suitable for analysis.

If processing is delayed samples should be refrigerated provided they can reach the laboratory within 72 hours. If this is not possible, samples should be frozen immediately on receipt and sent to the laboratory as soon as possible (preferred method of storage).

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SAMPLE REQUIREMENTS FOR COAGULATION TESTS

PROCEDURE

Sample Requirements and Collection

  • Patients should be relaxed pre-venepuncture. Excessive stress and exercise will increase FVIII, vWF antigen and fibrinolysis. Venous occlusion should be avoided.
  • Difficult venepuncture with trauma may lead to platelet activation with release of PF4 fromalpha granules.
  • Venous blood should be collected into coagulation tubes containing Sodium Citrate 3.2%, 0.105M, 3ml.
  • Specimens must be mixed immediately post venepuncture to avoid clot activation, by GENTLY inverting the tubes 5 to 10 times.
  • The ratio of whole blood to anticoagulant is crucial. Under-filled specimens will not be processed as over- or under-filled tubes can adversely affect results.
  • Any warfarin treatment should be mentioned on the request form.

Transportation and Storage

  • PT/INR specimens should ideally be analysed within 12 hours of collection and transported to the laboratory at room temperature.
  • APTT and Fibrinogen should ideally be analysed within 4 hours of collection. Where this is not possible please centrifuge at room temperature (RT) @3000rpm (1500g) for at least 15 minutes, and then carefully remove the plasma from the cells, transfer to a fresh plastic plain tube and freeze at -20oC.
  • Non-frozen coagulation specimens should be transported at RT ASAP to avoid deterioration of labile factors V and VIII.
  • Collection of blood through intravenous lines that have been previously flushed with heparin should be avoided. In the event blood is drawn from an indwelling catheter, the line should be flushed with 5ml of saline, and the first 5ml of blood or 6 times the line volume be drawn off and discarded before coagulation tube is filled.

Plasma Sample Stability (CLSI H21-A5)

  • PT 24 hours @ RT or 2 weeks @ -20oC
  • APTT 4 hours @ RT or 2 weeks @ -20oC & 12 Months @ -70oC
  • Fibrinogen - 4 hours @ RT `

ESR Ref Ranges
Units of Measurement
MALE
FEMALE
>50 Years
mm/hr
0 - ≤12
0 - ≤15
<50 Years
mm/hr
0 - ≤8
0 - ≤10
Analyte
Units of Measurement
MALE
FEMALE
WBC
10^9/L
4.0 - 10.0
4.0 - 10.0
RBC
10^12/L
4.5 - 5.5
3.8 - 4.8
HB
g/dL
13.0 - 17.0
12.0 - 15.0
HCT
L/L
0.400 - 0.500
0.360 - 0.460
MCV
fL
83 - 101
83 - 101
MCH
pg
27 - 32
27 - 32
MCHC
g/dL
31.5 - 34.5
31.5 - 34.5
PLT
10^9/L
150 - 410
150 - 410
MPV
fL
N/A
N/A
RDW
%
11.6 - 14.0
11.6 - 14.0
#Neut
10^9/L
2.0 - 7.0
2.0 - 7.0
#Lymph
10^9/L
1.0 - 3.0
1.0 - 3.0
#Mono
10^9/L
0.2 - 1.0
0.2 - 1.0
#Eos
10^9/L
0.02 - 0.50
0.02 - 0.50
#Baso
10^9/L
0.02 - 0.10
0.02 - 0.10
Analyte
Units of Measurement
MALE
FEMALE
WBC
10^9/L
Up to 1 year (6.00-16.00)
Up to 6 years (5.00-15.00)
Up to 12 years (5.00-13.00)
Up to 18 years (3.88-10.49)
Up to 1 year (6.00-16.00)
Up to 6 years (5.00-15.00)
Up to 12 years (5.00-13.00)
Up to 18 years (3.88-10.49)
RBC
10^12/L
Up to 1 year (3.90-5.10)
Up to 12 years (4.00-5.20)
Up to 18 years (4.28-5.59)
Up to 1 year (3.90-5.10)
Up to 12 years (4.00-5.20)
Up to 18 years (3.73-5.02)
HB
g/dL
Up to 1 year (11.1-14.1)
Up to 6 years (11.0-14.0)
Up to 12 years (11.5-15.5)
Up to 18 years (13.5-17.2)
Up to 1 year (11.1-14.1)
Up to 6 years (11.0-14.0)
Up to 12 years (11.5-15.5)
Up to 18 years (11.3-15.2)
HCT
L/L
Up to 1 year (0.300-0.380)
Up to 6 years (0.340-0.400)
Up to 12 years (0.350-0.450)
Up to 18 years (0.381-0.499)
Up to 1 year (0.300-0.380)
Up to 6 years (0.340-0.400)
Up to 12 years (0.350-0.450)
Up to 18 years (0.323-0.462)
MCV
fL
Up to 1 year (72.0-84.0)
Up to 6 years (75.0-87.0)
Up to 12 years (77.0-95.0)
Up to 18 years (83.1-99.1)
Up to 1 year (72.0-84.0)
Up to 6 years (75.0-87.0)
Up to 12 years (77.0-95.0)
Up to 18 years (83.1-99.1)
MCH
pg
Up to 1 year (25.0-29.0)
Up to 6 years (24.0-30.0)
Up to 12 years (25.0-33.0)
Up to 18 years (28.3-33.9)
Up to 1 year (25.0-29.0)
Up to 6 years (24.0-30.0)
Up to 12 years (25.0-33.0)
Up to 18 years (28.3-33.9)
MCHC
g/dL
Up to 1 year (32.0-36.0)
Up to 6 years (31.0-37.0)
Up to 12 years (31.0-37.0)
Up to 18 years (32.1-36.6)
Up to 1 year (32.0-36.0)
Up to 6 years (31.0-37.0)
Up to 12 years (31.0-37.0)
Up to 18 years (32.1-36.6)
PLT
10^9/L
Up to 1 year (200-550)
Up to 6 years (200-490)
Up to 12 years (170-450)
Up to 18 years (164-382)
Up to 1 year (200-550)
Up to 6 years (200-490)
Up to 12 years (170-450)
Up to 18 years (164-382)
RDW
%
No separate paediatric ranges
No separate paediatric ranges
#Neut
10^9/L
Up to 1 year (1.00-7.000)
Up to 6 years (1.50-8.00)
Up to 12 years (2.00-8.00)
Up to 18 years (1.56-6.52)
Up to 1 year (1.00-7.000)
Up to 6 years (1.50-8.00)
Up to 12 years (2.00-8.00)
Up to 18 years (1.56-6.52)
#Lymph
10^9/L
Up to 1 year (3.50-11.00)
Up to 6 years (6.00-9.00)
Up to 12 years (1.00-5.00)
Up to 18 years (1.01-3.13)
Up to 1 year (3.50-11.00)
Up to 6 years (6.00-9.00)
Up to 12 years (1.00-5.00)
Up to 18 years (1.01-3.13)
#Mono
10^9/L
Up to 1 year (0.20-1.00)
Up to 6 years (0.20-1.00)
Up to 12 years (0.20-1.00)
Up to 18 years (1.01-3.13)
Up to 1 year (0.20-1.00)
Up to 6 years (0.20-1.00)
Up to 12 years (0.20-1.00)
Up to 18 years (1.01-3.13)
#Eos
10^9/L
Up to 12 years (0.10-1.00)
Up to 18 years (0.05-0.51)
Up to 12 years (0.10-1.00)
Up to 18 years (0.05-0.51)
#Baso
10^9/L
Up to 1 day (0.00-0.64)
Up to 7 days (0.00-0.25)
Up to 14 years (0.00-0.23)
Up to 18 years (0.02-0.15)
Up to 1 day (0.00-0.64)
Up to 7 days (0.00-0.25)
Up to 14 years (0.00-0.23)
Up to 18 years (0.02-0.15)
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