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 hei lmannii (Hh, also known as Gastrospirillum hominis) may be a less freq uent gastric pathogen about which less is known. Patients and Methods. -We evaluated 1223 gastric biopsies from 1042 upper endoscopies with b iopsies performed over 1 year. Spiral bacteria were specifically sough t in biopsies from 912 endoscopies. Clinical and pathologic data from patients with unusual spiral bacteria were tabulated and sera were eva luated for anti-Hp antibodies. Results.-The histologic prevalences of Hp and Hh-like bacteria were 59% and 0.5%, respectively, In 912 endosc opies. All four patients with Hh-like spiral bacteria had gastrointest inal symptoms and histologic gastritis. Two had immigrated from the Ph ilippines and one from Belgium. Endoscopic findings and clinical cours e varied. One improved spontaneously; one improved following antibioti c therapy. One patient's symptoms and bacteria persisted without thera py. One patient coinfected with Hp was treated with apparent clearance of Hh but persistence of Hp. Conclusions.-Helicobacter heilmannii-lik e bacteria can be distinguished from Hp with routine histologic stains ; both bacteria are irregularly distributed. Helicobacter heilmannii a ppears to be a significant though uncommon cause of gastric inflammati on. Some patients with Hh-like bacteria may benefit from anti-Hp thera py.