Elongated Helicobacter pylori in gastric mucosa of children associated with gastric disease

Two human gastric pathogens, Helicobacter pylori and Helicobacter heilmannii are apparently different genetically as well as morphologically. H. pylori have short spiral morphology while H. heilmannii is a long spiral bacterium with four or more turns. In this study, we observed elongated, spiral, Gram-negative organisms in crush smears of antral biopsies from two children with upper abdominal pain and one with celiac disease; all these biopsies were positive for rapid urease test. Histologically the children had mild to moderate gastritis. Ultra-structurally, the organisms were more elongated than H. pylori and spiral shaped with periplasmic space. They were grown on chocolate Brucella agar and colonies were identified as H. pylori biochemically and by urease gene based polymerase chain reaction. Nuclear magnetic resonance study of sonicated extracts of these organisms showed similar metabolic peaks as H. pylori. 16S-rDNA sequencing results confirmed that the isolated organisms were H. pylori. The study suggests that a morphologically different (elongated) form of H. pylori strain exists in the stomach of children and is associated with gastric pathology.