Efficacy of swab-based RUT in detecting H. pylori infection: a systematic review and meta-analysis

Helicobacter pylori (H. pylori) is a gram-negative bacterium found in the gastric mucosa of humans. In this systematic review, our objective was to assess the diagnostic performance of the swab technique in detecting H. pylori infection. We followed the PRISMA guidelines and searched four databases for studies comparing the efficacy of swabs or sweeping techniques in detecting H. pylori infection. Outcomes were diagnostic accuracy measures, such as sensitivity and specificity. Four studies with 658 patients were included. Compared to conventional diagnosis methods, overall sensitivity was 0.93, with a 95% CI (0.85; 0.97). A confusion matrix was used to summarize the previously mentioned results. Gastric swabs reported a high sensitivity of 93.7%, with a high number of true positives = 285. However, test specificity is moderate (74.1%). These results indicate that gastric swab-based RUT may be helpful as an initial diagnostic test, specifically if a biopsy is difficult. More studies with large sample sizes are needed to confirm these findings.