Colonization by Pseudomonas aeruginosa and Staphylococcus aureus of Antral Biopsy Specimens from Gastritis Patients Uninfected with Helicobacter Pylori

Vida Kachuei,1 Amin Talebi Bezmin Abadi,1 Farid Rahimi,2 Mojgan Forootan3 1Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; 2Research School of Biology, The Australian National University, Canberra, Australia; 3Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, IranCorrespondence: Amin Talebi Bezmin AbadiDepartment of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, P.o. Box 14115-111, Tehran, IranTel +98 21 8288-4883Email Amin.talebi@modares.ac.irPurpose: Roles and incidence of some microorganisms that transiently or permanently colonize the human stomach are still unknown despite advances in gastroenterology. We aimed to examine the incidence of four microorganisms, Helicobacter pylori, Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis, in the antral biopsy specimens of patients with gastroduodenal conditions.Patients and Methods: Patients (67 females, 33 males; mean age = 49.5 years) were initially examined and diagnosed by a gastroenterologist at the Mehrad Hospital, Tehran, Iran. We enrolled those who underwent the upper gastrointestinal endoscopy because of gastroduodenal conditions. Two antral biopsy samples were taken by endoscopy; the first sample was used for the “rapid urease test” to confirm H. pylori. The second was used for DNA extraction and PCR analyses with specific, corresponding primer sets to establish the presence of the four microorganisms. Our study was approved by the Ethics Committee at the Tarbiat Modares University, Tehran.Results: Based on pathology and endoscopy findings, we divided the patients into three groups: 62 presented with gastritis, 18 with duodenal ulcer, and 20 gastric ulcer. The number of patients with P. aeruginosa but without H. pylori significantly differed from the number of those co-infected with both microorganisms (P = 0.03). Additionally, a similar significance was found between the incidence of S. aureus in patients without H. pylori and those with both infections (P = 0.04). Our results indicated that a significant number of patients with gastritis were colonized with P. aeruginosa or S. aureus without being co-infected with H. pylori (P < 0.001). Interestingly, the incidence of colonization by P. aeruginosa of patients without H. pylori (45/49, 91.8%) was higher than that by S. aureus (28/49, 57%).Conclusion: The number of patients without H. pylori but with P. aeruginosa or with S. aureus infection significantly differed from that with both infections, respectively. Our study thus shows that patients without H. pylori infection are prone to be colonized by P. aeruginosa or S. aureus, indicating that targeted antibiotic regimens are necessary for clinically treating them.Keywords: gastritis, Helicobacter pylori, microbiota, PCR, Pseudomonas aeruginosa, Staphylococcus aureus