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Kim, Jung, Hwang, Ahn, Mun, Myoung, Park, Jeong, Im, Oh, Jeong, Park, Kim, Cho, Kim, and Jung: Culture and Polymerase Chain Reaction of Helicobacter pylori from Rectal and Terminal Ileal Fluid after Polyethylene Glycol (ColyteⓇ) Ingestion in Healthy Adults with Positive Urea Breath Test
Original Article

Korean J Gastroenterol 2010;56(1):27-32.

Published online: 21 February 2010

DOI: https://doi.org/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Ⓡ) Ingestion in Healthy Adults with Positive Urea Breath Test

Do Hyun Kim, M.D., Hong Myong Jung, M.D., Young Jun Hwang, M.D., Yong Soo Ahn, M.D., Jang Sik Mun, M.D., Bo Hyun Myoung, M.D., Hyeuk Park, M.D., Eun Joo Jeong, Yun Mi Im, Hyun Min Oh, Hui Yeong Jeong, Chul Park∗, Hyung Rag Kim∗, Eun Hae Cho, M.D.†, Ho Dong Kim, M.D., Young Do Jung, M.D., Ph.D.‡

Departments of Internal Medicine, Saint Carollo Hosipital, Suncheon, Korea

∗Laboratory Medicine, Saint Carollo Hosipital, Suncheon, Korea

†Greencross Reference Laboratory, Yongin, Korea

‡Department of Biochemistry, Chonnam National University Medical School, Gwangju, Korea

Correspondence to: Ho Dong Kim, M.D. Department of Gastroenterology, Saint Carollo Hosipital, 1742, Jorye-dong, Suncheon 540-719, Korea Tel: +82-61-720-2127, Fax: +82-61-720-6049 E-mail: raphael65@hanmail.net

Received 28 January 2010       Accepted 25 May 2010

Copyright © 2010 The Korean Journal of Gastroenterology

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 fla A (16/20, 80.0% and 17/20, 85.0%), 16S rRNA gene (16/20, 80.0% and 17/20, 85.0%), cag A (10/20, 50.0% and 12/20, 60.0%), and ure C (9/20, 45% and 11/20, 54.5%) from the rectal fluid and the terminal ileal fluid, respectively. The specificity and sensitivity of ure C 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.

Keywords: Urea breath test, Helicobacter pylori, Polyethylene glycol, H. pylori DNA (fla A, 16S rRNA gene and cag A)

REFERENCES

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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.
kjg-56-27f1.tif
Table 1.
Summary of PCR and Culture Results from Rectal Fluid and Terminal Ileal Fluid of 20 Subjects Infected with Helicobacter pylori
cag A fla A 16S rRNA ure C Culture cag A fla A 16S rRNA ure C Culture
1 − ＋ ＋ − − 1 ＋ ＋ ＋ ＋ ＋
2 − − − − − 2 − − − − −
3 ＋ ＋ ＋ ＋ ＋ 3 ＋ ＋ ＋ ＋ ＋
4 ＋ ＋ ＋ ＋ ＋ 4 ＋ ＋ ＋ ＋ ＋
5 − − − − − 5 ＋ ＋ ＋ − −
6 ＋ ＋ ＋ ＋ ＋ 6 − ＋ ＋ − −
7 − − − − − 7 − − − − −
8 − ＋ ＋ ＋ ＋ 8 − ＋ ＋ ＋ ＋
9 − ＋ ＋ − − 9 ＋ ＋ ＋ − −
10 − ＋ ＋ − − 10 − ＋ ＋ − −
11 − − − − − 11 ＋ ＋ ＋ ＋ ＋
12 ＋ ＋ ＋ − − 12 ＋ ＋ ＋ − −
13 ＋ ＋ ＋ ＋ ＋ 13 ＋ ＋ ＋ ＋ ＋
14 ＋ ＋ ＋ ＋ ＋ 14 ＋ ＋ ＋ ＋ ＋
15 − ＋ ＋ − − 15 − ＋ ＋ − −
16 ＋ ＋ ＋ ＋ ＋ 16 ＋ ＋ ＋ ＋ ＋
17 ＋ ＋ ＋ − − 17 − − − − −
18 − ＋ ＋ − − 18 − ＋ ＋ ＋ ＋
19 ＋ ＋ ＋ ＋ ＋ 19 ＋ ＋ ＋ ＋ ＋
20 ＋ ＋ ＋ ＋ ＋ 20 ＋ ＋ ＋ ＋ ＋
Table 2.
Comparison of Different H. pylori DNA in Culture Positive Specimens from the Rectal Fluid
cag A fla A 16s rRNA ure C
Sensitivity 88.9 100 100 100
Specificity 81.8 36.4 36.4 100
PPV 80 56.3 56.3 100
NPV 90 100 100 100

PPV, positive predictive value; NPV, negative predictive value.

Table 3.
Comparison of Different H. pylori DNA in Culture Positive Specimens from the Terminal Ileal Fluid
cag A fla A 16s rRNA ure C
Sensitivity 88.9 100 100 100
Specificity 66.7 33.3 33.3 100
PPV 75.0 64.7 64.7 100
NPV 75.0 100 100 100

PPV, positive predictive value; NPV, negative predictive value.

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