Helicobacter heilmannii-like spiral bacteria in gastric mucosal biopsies. Prevalence and clinical significance.
BACKGROUND
Gastric Helicobacter pylori (Hp) is highly associated with histological gastritis and peptic ulcer disease, yet Helicobacter heilmannii (Hh, also known as Gastrospirillum hominis) may be a less frequent gastric pathogen about which less is known.


METHODS
We evaluated 1223 gastric biopsies from 1042 upper endoscopies with biopsies performed over 1 year. Spiral bacteria were specifically sought in biopsies from 912 endoscopies. Clinical and pathologic data from patients with unusual spiral bacteria were tabulated and sera were evaluated for anti-Hp antibodies.


RESULTS
The histologic prevalences of Hp and Hh-like bacteria were 59% and 0.5%, respectively, in 912 endoscopies. All four patients with Hh-like spiral bacteria had gastrointestinal symptoms and histologic gastritis. Two had immigrated from the Philippines and one from Belgium. Endoscopic findings and clinical course varied. One improved spontaneously; one improved following antibiotic therapy. One patient's symptoms and bacteria persisted without therapy. One patient coinfected with Hp was treated with apparent clearance of Hh but persistence of Hp.


CONCLUSIONS
Helicobacter heilmannii-like bacteria can be distinguished from Hp with routine histologic stains; both bacteria are irregularly distributed. Helicobacter heilmannii appears to be a significant though uncommon cause of gastric inflammation. Some patients with Hh-like bacteria may benefit from anti-Hp therapy.
Hilzenrat
N
N
Department of Medicine, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada.
Lamoureux
E
E
Weintrub
I
I
Alpert
E
E
Lichter
M
M
Alpert
L
L
D000328:Adult; D000368:Aged; D001706:Biopsy; D004724:Endoscopy; D005753:Gastric Mucosa / Q000382:microbiology* / Q000473:pathology; D016998:Helicobacter / Q000145:classification / Q000302:isolation & purification*; D006801:Humans; D007249:Inflammation / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013272:Stomach Diseases / Q000150:complications / Q000382:microbiology