Isolation of Helicobacter pylori from feces of patients with dyspepsia in the United Kingdom.

Background/aims: Epidemiological studies suggest that fecal-oral spread of Helicobacter pylori potentially represents an important route of infection. However, the bacterium has never been isolated from feces of adults in the developed world. This study attempted to isolate H. pylori from stool specimens donated by 36 adults from the United Kingdom who had dyspepsia.

Methods: Fresh fecal samples were obtained and, after centrifugation to harvest bacteria, cultured onto H. pylori selective growth media. Pure colonies of H. pylori were obtained by subculture and were then analyzed using polymerase chain reaction to confirm genotypic identity.

Results: H. pylori was isolated from feces in 12 of 25 subjects with dyspepsia proven to be H. pylori-positive at endoscopy and/or 14C urea breath test. Initial bacterial identification was made on the basis of various phenotypic methods. Genotypic confirmation that the bacterium was indeed H. pylori was also made.

Conclusions: This study is the first to conclusively show that H. pylori can be isolated from feces obtained from adults in the United Kingdom. The implication of this finding is that transmission of H. pylori infection by the fecal-oral route is feasible.