Development of a culture method for detection of Helicobacter pylori in groundwater

In the U.S. alone, about 5,000,000 people are diagnosed annually with ulcers, 1,000,000 are hospitalized, 40,000 undergo surgery, and 6,500 die from ulcer-related complications (Poms, 2001: Levin, 1998). Once thought to be a result of stress and/or diet, ulcers are now almost exclusively attributed to infection with the bacteria Helicobacter pylori. Laboratory diagnosis of H. pylori has become a standard procedure in the management of dyspeptic patients. Although transmission of the organism through the fecal/oral route is the assumed infection route, the possible mechanisms of human infection such as food, person to person contact, water or fomites are not clearly understood. There are few reports in the literature suggesting transmission of H. pylori to humans via groundwater (Hegarty, 1999; Hulten, 1995 & 1998). Methods of detection used in those studies were relatively complex and costly (polymerase chain reaction; immunomagnetic separation) and unfortunately, didn’t determine if the detected organisms were in fact viable or infectious. The work reported here focused on the development of a microbiological plating media that selects viable H. pylori organisms from samples containing mixed microbial populations, which could then be used for routine screening of ground and/or surface water for the presence of H. pylori. Efforts have resulted in a media formulation that allows the growth of Helicobacter while subsequently excluding common waterborne microbial background contaminants such as gram positive cocci and bacilli, enterobacteriaceae, gram negative bacilli, fungi, and pseudomonads. The laboratory-tested plating media was used to survey a cross section of Wisconsin groundwaters to further evaluate the efficacy of the media for recovering H. pylori from water samples and to begin a data base of H. pylori occurrence.