Korean J Gastroenterol.  2010 Jul;56(1):27-32. 10.4166/kjg.2010.56.1.27.

Culture and Polymerase Chain Reaction of Helicobacter pylori from Rectal and Terminal Ileal Fluid after Polyethylene Glycol (Colyte(R)) Ingestion in Healthy Adults with Positive Urea Breath Test

• Kim DH
• Jung HM
• Hwang YJ
• Ahn YS
• Mun JS
• Myoung BH
• Park H
• Jeong EJ
• Im YM
• Oh HM
• Jeong HY
• Park C
• Kim HR
• Cho EH
• Kim HD
• Jung YD

• KMID: 1775875
• DOI: http://doi.org/10.4166/kjg.2010.56.1.27

Abstract

BACKGROUND/AIMS
Helicobacter pylori (H. pylori) transmission route is not yet clearly understood. Isolating H. pylori from stool, saliva, and vomitus is very difficult. However, H. pylori could be cultured from feces in the setting of rapid gastrointestinal tract transit. The aim of this study was to isolate H. pylori by culture and PCR in the rectum and terminal ileum during colonoscopy.
METHODS
Twenty subjects with positive UBT (urea breath test) were included. We performed polymerase chain reaction (PCR) test and culture of H. pylori with the rectal fluid and terminal ileal fluid during colonoscopy.
RESULTS
H. pylori was cultured with rectal fluid from 9 (45.0%) of 20 subjects and with ileal fluid from 11 (55.0%) of 20 subjects. H. pylori was a little more frequently cultured from the terminal ileal fluid than the rectal fluid without statistical significance (p>0.05). PCR test detected flaA (16/20, 80.0% and 17/20, 85.0%), 16S rRNA gene (16/20, 80.0% and 17/20, 85.0%), cagA (10/20, 50.0% and 12/20, 60.0%), and ureC (9/20, 45% and 11/20, 54.5%) from the rectal fluid and the terminal ileal fluid, respectively. The specificity and sensitivity of ureC were 100%.
CONCLUSIONS
H. pylori could be cultured from the rectal fluid and terminal ileal fluid in the setting of rapid gastrointestinal tract transit. These results suggest of fecal-oral transmission of H. pylori.

Keyword

Urea breath test; Helicobacter pylori; Polyethylene glycol; H. pylori DNA (flaA, 16S rRNA gene and cagA)

MeSH Terms

Adult
Antigens, Bacterial/genetics
Bacterial Proteins/genetics
Breath Tests
Electrolytes/administration & dosage
Feces/microbiology
Female
Helicobacter Infections/*diagnosis/transmission
Helicobacter pylori/genetics/*isolation & purification
Humans
Ileum/*microbiology
Male
Middle Aged
Polyethylene Glycols/administration & dosage
Polymerase Chain Reaction
RNA, Ribosomal, 16S/genetics
Rectum/*microbiology
Sensitivity and Specificity
Urea/analysis
Urease/genetics

Figure

• 

  Fig. 1. Detection of H. pylori DNA in the rectal fluid and terminal ileal fluid by PCR. M, marker; P, positive control; R, rectal fluid; T, terminal ileal fluid.

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