Quantitation of bacteria in gastric biopsy specimen from patients with gastrointestinal disorders: relationship between counts and clinical features

Background: H. pylori is the only bacteria that infect humans gastric for which endoscopy examination is routinely recommended. The risk of development of gastrointestinal disorders (GIDs) in the presence of H. pylori infection depends on a variety of factors including bacterial, host, and environmental ones that mostly relate to the pattern of bacterial load. The aim of this study is to evaluate the relationship between H. pylori disease associated clinical features and bacterial count. Methods: A prospective study of the concentrations of bacteria in the gastric and their relationship to clinical features was conducted with 200 H. pylori suspected patients with GIDs. Initially, clinical status was evaluated and recorded by questionnaire. Then, RUT and 16SrRNA PCR were performed for identification of H. pylori. Finally, gastric biopsy specimens were analyzed for bacterial count by using specific primers and probe for 23SrRNA and using Taq-Man real-time PCR technology. Statistical analyses were performed using the c2 test. Pvalues less than 0.05 were taken to indicate statistical significance. Results: Of whom 200 samples, 164 (82%) had confirmed H. pylori positive. For 164 patients with GIDs, the count of H. pylori in gastric biopsies were a value of 104 to 1012 CFU/ml. The results revealed that more relationships between acid reflux and 104 CFU/ml (p = 0.006) and vomiting and 104 CFU/ml (p = 0.046). Conclusion: This study has demonstrated a relationship between bacterial load and clinical features in patients with GIDs. In conclusion, GIDs are similar to many other bacterial infections in that bacterial burden in the host is related to clinical features. Further studies are required to determine whether this is a function of the host, the infecting strain, or a combination of the two.