TABLE 1

Selected studies examining the prevalence of human colonic spirochetosis

StudyReferenceDetection method(s)aLocation(s)Study populationYr(s) of specimen collectionSpecimen(s)Total subjectsB. aalborgi positiveB. pilosicoli positiveTotal HCS casesPercent positiveComments
Lee et al. (1971)2EM, HE, SS, PASGlasgow, Scotland, UKPatients with diarrhea or suspected cancer1961Rectal biopsy specimen144b106.9Includes the cases from Harland and Lee (3)
Lee et al. (1971)2EM, HE, SS, PASGlasgow, Scotland, UKAppendectomy cases1963–1966Excised appendix790627.8Included acute appendicitis (7/144 [4.4%]), “simulated” appendicitis (15/523 [9.8%]), incidental appendectomy (4/107 [4.4%])
McMillan and Lee (1981)11HEGlasgow, Scotland, UKMSMcNIdColorectal biopsy specimen; FFPEe1003636.0
McMillan and Lee (1981)11HEGlasgow, Scotland, UKHeterosexual menNIColorectal biopsy specimen; FFPE6723.0
Mathan and Mathan (1985)26EMSouthern IndiaHealthy adultsNIRectal biopsy specimen14964.3
Cooper et al. (1986)27EMSouthhampton, Hampshire, England, UKMSMNIRectal biopsy specimen8562.5Reduction in microvillus density observed
Cooper et al. (1986)27EMSouthhampton, Hampshire, England, UKHeterosexual menNIRectal biopsy specimen500.0
Surawicz et al. (1986)28HE, AB, SSSeattle, WAMSMNIRectal biopsy specimen1002828.0
Tompkins et al. (1986)29CGreat Britain, UKHealthy adultsNIColorectal biopsy specimen1,527231.5All positive specimens from either MSM or persons of Asian ethnicity
Barrett (1990)30CMuskat Region, OmanHealthy children and adults1988Feces2927826.7
Barrett (1990)30CMuskat Region, OmanHospitalized patients1988Feces1,00011411.4
Lee and Hampson (1992)12CWestern AustraliaAboriginal children and adults1989–1991Feces1815932.6Isolates were shown subsequently to be B. pilosicoli (31)
Lee and Hampson (1992)12CWestern Australia, Northern TerritoryNon-Aboriginal children and adults1989–1991Feces69581.2
De Brito et al. (1996)32HE, SS, IHC, EMBrazilPatients with GIf symptomsNIRectal and sigmoidal colonic biopsy specimens28241.4
Trivett-Moore et al. (1998)13HE, EM, CSydney, AustraliaMSM attending a sexual health clinicNIRectal biopsy specimens41(0)(13)2253.7B. pilosicoli isolated from biopsy samples positive (11/22) and negative (2/19) for HCS by HE and EM
Brooke et al. (2001)10CWestern AustraliaAboriginal rural patients with GI complaints1998–1999Feces151015159.9High proportion of isolates from subjects aged 2 to 5
Brooke et al. (2001)10CWestern AustraliaNon-Aboriginal rural patients with GI complaints1998–1999Feces1420000
Brooke et al. (2001)10CAustraliaEntering migrants to Australia1998–1999Feces2270242410.6Isolates/subjects for migrants from Asia (2/8), Eastern Europe (3/94), the Middle East (9/65), and Africa (10/50)
Margawani et al. (2004)33CBali, IndonesiaAdult and child residents1999Feces (August)5000595911.8375 subjects were sampled at both time points
Margawani et al. (2004)33CBali, IndonesiaAdult and child residents1999Feces (December)4920626212.6375 subjects were sampled at both time points
Esteve et al. (2006)16HE, SS, PAS, PCRBarcelona, SpainPatients with chronic watery diarrhea and control subjects1994–2004Colonic biopsy samples1,176(2)(2)80.7Of 8 subjects positive for HCS by light microscopy, 2 were positive for B. pilosicoli and 2 for B. aalborgi by PCR
Calderaro et al. (2007)34PCR, CParma, ItalyPatients with suspected gastrointestinal infections2002–2006Feces, colonic biopsy samples, FFPE234135166.8Two patients were coinfected with B. aalborgi and B. pilosicoli
Tanahashi et al. (2008)35HE, SS, IHC, immuno-EM, PCROita, JapanPatients with colonoscopy or surgical resections2005–2006Colonic biopsy samples, FFPE2,556203200.811 cases identified by HE, SS, and IHC. 20 cases positive for B. aalborgi by PCR; 3 cases also positive for B. pilosicoli
Ichimata et al. (2017)36HEAsahi, Matsumoto, JapanPatients <20 yrs of age with gastrointestinal symptomsNIBiopsy specimens, surgical specimens47910.2
Thorell et al. (2019)8HE, IHC, SS, CSwedenAdult population2000–2006Biopsy samples of terminal ileum and colon from cecum to rectum (5 sites)745131172.3HCS cases correspond to those described previously by Walker et al. (18); 3 subjects who were positive by HE, IHC, and SS positive were negative by culture
Mikosza et al. (2001)37PCRAustraliaHCS subjects (by HE)NIColon, colorectal, cecum, and appendix biopsy samples; FFPEb282442692.92 subjects were positive for both B. aalborgi and B. pilosicoli; 2 subjects were negative by PCR
Mikosza et al. (2004)38PCRAustralia (20); USA (1); France (1); Norway (2)HCS subjects (by HE)NIColon, colorectal, cecum, and appendix biopsy samples; PET2422224100Prescreened for intestinal spirochetosis by histology
Westerman et al. (2012)39Real-time PCRThe NetherlandsHCS subjects (by HE, IHC)2001–2011Colon biopsy samples; FFPE5648956100Several genotypesg
Rojas et al. (2017)40FISHGermanyHCS subjects (by HE)NIIntestinal biopsy samples (from ileum to rectum); PET917784.6Prescreened for intestinal spirochetosis by histology; same specimens were analyzed by both FISH and PCR
Rojas et al. (2017)40PCRGermanyHCS subjects (by HE)NIIntestinal biopsy samples (from ileum to rectum); PET9153237582.4Prescreened for intestinal spirochetosis by histology; includes one subject with both B. aalborgi and B. pilosicoli
  • a In the studies described in references 37 to 40, specimens were prescreened for colonic spirochetosis. Abbreviations: AB, alcian blue-stained sections; C, culture; EM, transmission electron microscopy; FISH, fluorescent in situ hybridization; HE, hematoxylin and eosin-stained sections; IHC, immunohistochemistry; PAS, periodic acid-Schiff-stained sections; SS, silver-stained sections.

  • b —, species not determined.

  • c MSM, men who have sex with men.

  • d NI, not indicated.

  • e FFPE, formalin-fixed, paraffin-embedded tissue.

  • f GI, gastrointestinal.

  • g Includes 36 B. aalborgi cluster 1 organisms alone, 6 B. aalborgi cluster 2 (“B. hominis”) organisms alone, 6 B. pilosicoli organisms alone, 5 cluster 1 and cluster 2 organisms, 1 B. pilosicoli and cluster 2 organisms, and 2 B. pilosicoli, cluster 1, and cluster 2 organisms (triple positive).