Campylobacter concisus gastritis masquerading as Helicobacter pylori on gastric biopsy.
Elizabeth O Ferreira, Philippe Lagacé-Wiens, Julianne Klein
Author Information
Elizabeth O Ferreira: Department of Pathology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. ORCID
Philippe Lagacé-Wiens: Department of Medical Microbiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Julianne Klein: Department of Pathology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
OBJECTIVE: Campylobacter concisus is a Gram-negative rod closely related to Helicobacter pylori. We sought to identify gastric biopsies positive for C. concisus that had been misdiagnosed as H. pylori gastritis in our routine surgical pathology practice. MATERIALS AND METHODS: We performed a retrospective review of gastric biopsies in our regional microbiology and pathology electronic records to identify cases that were submitted for H. pylori testing in which C. consicus was identified on culture and how many had concurrent biopsies sent to pathology for histologic assessment over a two-year period (2017-2018). Pathologic findings in the gastric biopsies were reviewed and immunohistochemical staining for H. pylori was performed. RESULTS: 50 of 2191 gastric biopsy specimens submitted to microbiology in 2017-18 grew C. concisus (2.3%), compared to 168 in which H. pylori was identified (7.7%). Twenty-eight cases had concurrent histology. A total of four cases (three from 2017 and one from 2018) demonstrated organisms morphologically identical to H. pylori in the H&E sections, of which all were H. pylori immunoreactive. CONCLUSIONS: Our case series is the first to demonstrate that C. concisus can mimic H. pylori gastritis in routine biopsy pathology.
El-Serag HB, Kao JY, Kanwal F, et al. Houston consensus conference on testing for Helicobacter pylori infection in the United States. Clin Gastroenterol Hepatol. 2018;16(7):992-1002.
Sohn SH, Kim N, Jo HJ, et al. Analysis of gastric body microbiota by pyrosequencing: Possible role of bacteria other than Helicobacter pylori in the gastric carcinogenesis. J Cancer Prev. 2017;22(2):115-125.
Liu F, Ma R, Wang Y, Zhang L. The clinical importance of Campylobacter concisus and other human hosted Campylobacter species. Front Cell Infect Microbiol. 2018;243:1-22. Doi: 10.3389/fcimb.2018.00243
Tanner ACR, Badger S, Lai C, et al. ,WoZinella succinogenes (Vibrio succinogenesWolin et al.) comb. nov., and Description of Bacteroides gracilis sp.nov., Wolinella recta sp. nov., Campylobacter concisus sp. nov., and Eikenella corrodens from Humans with Periodontal Disease. Int J Sys Bacteriol. 1981;4:432-445. doi:10.1099/00207713-31-4-432
Akutko K, Matusiewicz K. Campylobacter concisus as the etiologic agent of gastrointestinal diseases. Adv Clin Exp Med. 2017;26(1):149-154.
Kaakoush NO, Mitchell HM. Campylobacter concisus-a new player in intestinal disease. Front Cell Infect Microbiol. 2012;2:4.
Vandamme P, Falsen E, Pot B, Hoste B, Kersters K, De Ley J. Identification of EF group 22 campylobacters from gastroenteritis cases as Campylobacter concisus. J Clin Microbiol. 1989;27(8):1775-1781.
Hess DL, Pettersson AM, Rijnsburger MC, Herbrink P, Van Den Berg HP, Ang CW. Gastroenteritis caused by Campylobacter concisus. J Med Microbiol. 2012;61(5):746-749.
Nielsen HL, Engberg J, Ejlertsen T, Bücker R, Nielsen H. Short-term and medium-term clinical outcomes of Campylobacter concisus infection. Clin Microbiol Infect. 2012;18(11):E459-E465.
Ismail Y, Lee H, Riordan SM, Grimm MC, Zhang L. The effects of oral and enteric Campylobacter concisus strains on expression of TLR4, MD-2, TLR2, TLR5 and COX-2 in HT-29 cells. PLoS One. 2013;8(2):e56888.
Zhang L, Lee H, Grimm MC, Riordan SM, Day AS, Lemberg DA. Campylobacter concisus and inflammatory bowel disease. World J Gastroenterology. 2014;20(5):1259.
Ma R, Sapwell N, Chung HK, et al. Investigation of the effects of pH and bile on the growth of oral Campylobacter concisus strains isolated from patients with inflammatory bowel disease and controls. J Med Microbiol. 2015;64(4):438-445.
Yde Aagaard ME, Frahm Kirk K, Linde Nielsen H, Harder Tarpgaard I, Bach Hansen J, Nielsen H. Campylobacter concisus is prevalent in the gastrointestinal tract of patients with microscopic colitis. Scand J Gastroenterol. 2020;55(8):924-930.
Aagaard ME, Kirk KF, Nielsen H, Nielsen HL. High genetic diversity in Campylobacter concisus isolates from patients with microscopic colitis. Gut Pathog. 2021;13(1):1-5.
Blackett KL, Siddhi SS, Cleary S, et al. Oesophageal bacterial biofilm changes in gastro-oesophageal reflux disease, Barrett's and oesophageal carcinoma: association or causality? Aliment Pharm Ther. 2013;37(11):1084-1092.
Cui J, Cui H, Yang M, et al. Tongue coating microbiome as a potential biomarker for gastritis including precancerous cascade. Protein Cell. 2019;10(7):496-509.
Von Rosenvinge EC, Song Y, White JR, Maddox C, Blanchard T, Fricke WF. Immune status, antibiotic medication and pH are associated with changes in the stomach fluid microbiota. ISME J. 2013;7(7):1354-1366.
Istivan TS, Coloe PJ. Phospholipase A in Gram-negative bacteria and its role in pathogenesis. Microbiol. 2006;152(5):1263-1274.
Istivan TS, Smith SC, Fry BN, Coloe PJ. Characterization of Campylobacter concisus hemolysins. FEMS Immunol Med Microbiol. 2008;54(2):224-235.
Jonkerst D, Stobberingh E, De Bruine A, Arends JW, Stockbrügger R. Evaluation of immunohistochemistry for the detection of Helicobacter pylori in gastric mucosal biopsies. J Infect. 1997;35(2):149-154.
Sabbagh P, Mohammadnia-Afrouzi M, Javanian M, et al. Diagnostic methods for Helicobacter pylori infection: ideals, options, and limitations. Eur J Clin Microbiol Infect Dis. 2019;38(1):55-66.
Vandenberg O, Houf K, Douat N, et al. Antimicrobial susceptibility of clinical isolates of non-jejuni/coli campylobacters and arcobacters from Belgium. J Antimicrob Chemother. 2006;57(5):908-913.
