The goal of this study was to develop a simple plating medium to allow large-scale screening of water samples for the presence of Helicobacter pylori. Five conventional plating media (brain heart infusion, brucella agar, Columbia blood agar base, campylobacter agar kit Skirrow, and HPSPA medium), each containing a commercial antibiotic supplement, were initially evaluated. Eight strains selected as common waterborne organisms (Acinetobacter, Aeromonas, Bacillus, Escherichia coli, Enterobacter, Enterococcus, Helicobacter pylori, and Pseudomonas strains) were individually plated onto each of these media. Three organisms (Acinetobacter, E. coli, and H. pylori) were able to grow on all five media. This growth was unacceptable since Helicobacter grows very slowly and competing organisms must be inhibited for up to 7 days. Therefore, a more selective medium (HP agar) containing a novel mixture of growth supplements plus amphotericin B and polymyxin B was developed. This medium also included a phenol red color indicator for urease production. Aliquots of nonsterile well water that contained native flora (Flavobacterium, Serratia, Citrobacter, Pasteurella, Ochrobactrum, Rahnella, and unidentified molds) and were further adulterated with the eight strains listed above (10 6 CFU of each strain per 100 ml) were spiked with H. pylori and were plated. In spite of the heavy mixed microbial load, only H. pylori colonies grew during 7 days of incubation at 37°C. The color indicator system allowed presumptive identification of H. pylori colonies sooner (12 to 20 h) than the conventional media tested allowed. The HP formulation developed in this study provides a medium with superior selectivity for H. pylori from mixed microbial populations in water and reduces the time required to complete the assay.A scientific breakthrough occurred in 1982 when J. R. Warren and B. Marshall isolated a bacterium and showed that it causes gastritis and stomach ulcers that affect millions of humans worldwide (10,12). Today this etiology has been proven to the extent that the National Institutes of Health recommends treatment with antibiotics for all patients with peptic ulcers, which are almost exclusively attributed to infection with the bacterium Helicobacter pylori (4). The scope of gastric illnesses around the world is vast, and in the United States alone, over 5,000,000 people are diagnosed annually with ulcers, 1,000,000 people are hospitalized, 40,000 people undergo surgery, and 6,500 people die from ulcer-related complications (11,21). Estimates suggest that as many as 50% of adult Americans carry the pathogen, most asymptomatically, and in lessdeveloped countries human carriers represent up to 90% of the populations (15).The source of human infection is not yet known, and until recently, the natural reservoir for H. pylori was thought to be the human gastrointestinal tract (1). However, the association of Helicobacter with nonhuman sources, such as livestock (23), domestic cats, (17), and vegetables (6), prompted researchers to look at en...