Thursday, April 05, 2012

The 30th Anniversary of the Culture of Helicobacter pylori

On Easter Thursday 1982, which was the 8th of April, we performed endoscopy on a man in his 60's who I recall had a recurrent bleeding duodenal ulcer.  This was a major problem for him because he also had a heart valve problem and therefore was required to take anticoagulants (making him more likely to bleed from the ulcer).  Dr Warren and I were in the third week of a study of 100 consecutive endoscopy patients and we had already entered more than 30 patients in the study.  I took two gastric biopsies to the pathology lab and one to the micro lab (for Dr Pearman).
I have no idea what I did that Easter but I suspect that I was on-call as registrar in haematology with many very sick patients to attend to.  Luckily I lived only 15 minutes from Royal Perth Hospital.
In Perth, the Easter Break is four days (Good Friday to Easter Monday incl.) so the bacterial cultures which had been set up on the Thursday morning were not examined until Tuesday morning, at which time the typical "water spray" appearance of Helicobacter colonies were visible.
The next day, an excited John Pearman called me to come and see the bacteria they had grown from a patient cultured the previous Thursday.  He showed me the culture plates and we peered at the Gram stained smear of the bacteria through the lab microscope.  The bacteria were Gram-negative - pink (at least that part was correct) but were not obviously spiral - they were all shapes and sizes!  After 6 months of disappointment, I was not going to break out the champagne on such borderline evidence of success.  After all, why should we suddenly be able to grow the bacteria when all other attempts had failed?  What were we doing differently?  In the next week John's lab was able to culture Helicobacter (which we called Campylobacter in those days) from several more patients.  Reflecting on this, we realised that in the previous attempts, lab staff had been examining the plates after 48 hours then discarding them if nothing new was visible.  After all, biopsies covered in saliva and dragged up from the stomach through the channel of an endoscope would be severely contaminated with commensal organisms.  These irrelevant "commensal organisms" (fungus, oral streptococcus, bacillus and hundreds of other species) would be expected to completely cover the plates after 48 hours and obscure any new kind of bacteria.
But biopsy specimens taken from the human stomach for Helicobacter were a little different.  The wall of the stomach is exposed to a puddle of acid which kills most of the bacteria being swallowed from the mouth.  So the biopsy samples were sometimes almost sterile (except for Helicobacter pylori which lives under the protective mucus gel layer); and even non-selective blood agar plates could be incubated for 3-5 days with quite a few areas of clean agar visible upon which Helicobacter could slowly grow.
Normally, after two days, the lab technician would have discarded the cultures after seeing nothing worth keeping at the 48 hour inspection (Easter Saturday).  However, that Easter may have been particularly busy so that urgent cases took precedence over our clinical research; which was regarded more as a hobby than as science.  I recall that there was a MRSA (methicillin resistant staph-aureus) control program in the hospital that month so maybe the microbiology staff were overloaded.  In any case, on Easter Saturday, the technologist did not examine the research cultures and left them to sit for three more days until the Tuesday morning examination.  The first culture plate probably looked like this:

That first culture became the "type strain" of Helicobacter pylori, ATCC #11637.  This bacterial strain has been studied by thousands of research labs and costs £150 to obtain from the NCTC.  You can read about the type strain of Helicobacter pylori here: pdf file of NCTC citation copied on 2012-04-04

3 comments:

T said...

Hey Barry.
30 years ago, people had no idea H.Pylori even existed. Today Some sources claim that half the worlds population have this culture growing inside them.
That's pretty awesome.
I have a quick question for you. From all your research into this culture, did you ever discover it in people who had no gastritis/ulcers/discomfort in relation to their stomachs, but meerly would re-gurgitate mouthfuls of what they just ate, within a half hour of eating/drinking it.

I'm a 25 year old Irish male that has just been told I have H.Pylori after undergoing an endoscopy. I've had this "condition" (if you could call it that) where I reproduce the food/drink, exactly as it went down without any other stomach acids appearing with it.
I've asked several different doctors, and they never encountered a similar condition so I figured I'd go "right to the source" to see if you ever encountered a person with these symptoms/could it be related to the H.Pylori.

I'm starting my medication treatment which will last a week, and I'll post back here then to keep you updated.

In the mean time, stay away from those Petrie Dishes of culture :-)

Regards
T

Linda said...

Hello Barry, I tested positive for H-Pylori on 5/4. Treatment is being discussed. My health history is that of a kidney transplant (10 years+) and they are trying to figure out the best antibiotics for me and the meds I am currently taking plus a coupld of allergies I have. But, my question to you is my nutritionist and my pharmacist are at odd whether I should take or not take some supplements. Here is what is in question: Bifdo bacteria before every meal, glutamine before each meal, and acidophilus at bedtime. What are your thoughts? Thanks for your feedback. My son is a Microbiologist too:) I want an unbiased opinion...and I know he loves me and does not ever want to scare me. I just need a clear opinion? Thanks Linda!

Rodrigo Nunes Cal said...

Cool work!

Best regards,

Sincerely,

Rodrigo Nunes Cal

www.rodrigonunescal.wordpress.com