title: Esophageal bacteria and Barrett's esophagus: a preliminary report.
abstract: The objective of this study was to investigate if esophageal bacteria are associated with Barrett's esophagus (BE). This study was comprised of a retrospective (Part 1) and a subsequent prospective (Part 2) study. In Part 1, Gram stains were performed on esophageal biopsy specimens obtained in 47 patients. Bacteria were quantitated from 0 to 4. In Part 2, Gram stains and cultured bacterial counts of esophageal biopsies were obtained in 18 GERD patients (9 with BE and 9 without BE). Part 1 results were as follows. Bacteria were found in 37 of 47 esophageal biopsies. Quantitative bacterial stain scores for BE (2.5 +/- 0.2) were higher than for non-BE (1.5 +/- 0.3; P = 0.02). The quantitative bacterial stain scores correlated with increasing severity of dysplasia (r = 0.37, P = 0.028). In Part 2, bacteria were found in 8 of 18 esophageal biopsies by Gram stain (6 of 9 patients with BE vs. 2 of 9 non-BE). The distal esophageal bacterial stain scores in BE patients (1.6 +/- 0.5) were higher than in those without BE (0.4 +/- 0.3; P = 0.07). Patients on proton pump inhibitors tended to have higher bacterial stain scores (1.2 +/- 0.4) than patients who were not (0.7 +/- 0.3; P = 0.45). Bacterial colony counts were similar in patients with BE compared to those without BE. In conclusion, bacteria in esophageal biopsies were detected more often in BE than non-BE. Increasing bacterial stain scores were associated with metaplasia and increasing dysplasia. Esophageal bacteria, possibly related to stasis or gastric acid suppression therapy, may play a role in the pathogenesis of BE and dysplasia.
authors.affiliation: Section of Gastroenterology, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
authors.forename: Glenn L
authors.initials: GL
authors.lastname: Osias
authors.forename: Matthew Q
authors.initials: MQ
authors.lastname: Bromer
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Thomas
authors.forename: David
authors.initials: D
authors.lastname: Friedel
authors.forename: Larry S
authors.initials: LS
authors.lastname: Miller
authors.forename: Byungse
authors.initials: B
authors.lastname: Suh
authors.forename: Bennett
authors.initials: B
authors.lastname: Lorber
authors.forename: Henry P
authors.initials: HP
authors.lastname: Parkman
authors.forename: Robert S
authors.initials: RS
authors.lastname: Fisher
mesh_terms: D000328:Adult; D000368:Aged; D001419:Bacteria / Q000302:isolation & purification*; D001471:Barrett Esophagus / Q000382:microbiology* / Q000473:pathology; D015169:Colony Count, Microbial; D004941:Esophagitis / Q000382:microbiology / Q000473:pathology; D004947:Esophagus / Q000382:microbiology* / Q000473:pathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000382:microbiology; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors; D012189:Retrospective Studies
chemical_list: D054328:Proton Pump Inhibitors