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Human intestinal spirochetosis HIS is associated with overgrowth of the large intestine by spirochetes of the genus Brachyspira. The microbiological diagnosis of HIS is hampered by the fastidious nature and slow growth of Brachyspira spp.
In clinical practice, HIS is diagnosed histopathologically, and a significant portion of cases may be missed. Fluorescence in situ hybridization FISH is a molecular method that allows the visualization and identification of single bacteria within tissue sections.
In this study, we analyzed intestinal biopsy samples from five patients with possible HIS. All specimens yielded positive results by histopathological techniques. Sequences of two isolates clustered in the group of Brachyspira aalborgi , whereas in three cases, the sequences were highly similar to that of Brachyspira pilosicoli.
Three phylotypes showed mismatches at distinct nucleotide positions with Brachyspira sp. In addition, culture for Brachyspira was successful in three cases. FISH of biopsy samples resulted in strong, unequivocal signals of brush-like formations at the crypt surfaces. This technique allowed simultaneous visualization of single spirochetes and their identification as Brachyspira spp.
In conclusion, FISH provides a fast and accurate technique for the visualization and identification of intestinal spirochetes in tissue sections. It therefore represents a valuable tool for routine diagnosis of HIS. Human intestinal spirochetosis HIS is a histologically defined condition of the human distal intestinal tract characterized by helical microorganisms attached at one end to the surface epithelium of the colonic mucosa.