SUMMARY One thousand biopsy specimens obtained from 10 sites in the stomachs of 50 patients were examined for the presence of active chronic gastritis and Campylobacter pylori. All 32 patients with active chronic gastritis at 234 out of 320 sites were positive for Cpylori: 227 showed colonisation with Cpylori by the Warthin-Starry stain; and 222 were positive by culture. Cpylori was not found in 18 patients with inactive chronic gastritis or histologically normal mucosa. The area of C pylori colonisation was larger than the area of active chronic gastritis in 289 positive specimens on culture and 261 on staining, respectively, suggesting that Cpylori colonisation may precede the development of active chronic gastritis.It is concluded that patchy distribution of active chronic gastritis and Cpylori colonisation must be considered, particularly in serology or breath test studies where the histological examination serves as a reference. Furthermore, it may have important implications for the follow up of patients after antibacterial treatment. The topographic and specific association of C pylori and active chronic gastritis provides further evidence for the pathogenic role of C pylori in active chronic gastritis.Evidence has been accumulating for a primary pathogenic role for Campylobacter pylori in the development of active chronic gastritis.' This evidence has been challenged. A major argument against this is that it is also isolated from inactive chronic gastritis"'4 and from histologically normal mucosa. 214 The association between C pylori and active chronic gastritis has been reported to range from 82-97% in selected patients with duodenal ulcer or non-ulcer dyspepsia.2 '4.These unequivocal results on the association between C pylori and active chronic gastritis or other types of gastritis may be explained by either methodological shortcomings or an unspecific association between Cpylori and active chronic gastritis and other types of gastritis.As early work suggested that a considerable number ofpatients may have a patchy distribution ofgastritis'5 we designed this study to analyse further the sensitivity of endoscopic biopsies for detecting active chronic gastritis in the antrum and body ofthe stomach and its topographic association with C pylori detected by Warthin-Starry stain and culture.

The cellular fatty acid profiles of newly described campylobacters were determined on a polar, capillary cQlumnI. Six isolates of the gastric spiral organism, Campylobacter pylori subsp. mustelae, from ferrets from Australia, England, and the United States were all found to have a similar fatty acid profile which was different from that of C. pylori from humans; C. pylori subsp. mustelae did not have 3-hydroxyoctadecanoic acid (3-OH C18:0) and had much less tetradecanoic acid (C14:0) and much more hexadecanoic acid (C16:0). Inasmuch as

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Nineteen gastric biopsies were examined for campylobacter-like gram-negative bacteria. Such strains could be isolated in six out of the 19 biopsies, as confirmed histologically. The bacteria are sensitive to tetracycline, clindamycin, erythromycin, cefalothin, penicillin G and ampicillin and resistant to nalidixic acid and metronidazole. They grow in a 6% O2, 10% CO2 atmosphere at 37 degrees C.