The gastroenterologist view

Abstract

In 1983, Robin Warren and Barry Marshall published their first papers in Lancet on unidentified curved bacilli on gastric epithelium in active chronic gastritis (Warren 1983; Marshall 1983). Dr Warren, a pathologist at the Royal Perth Hospital, had for several years observed a high occurrence of small curved and S-shaped bacilli and a closely associated granulocyte infiltration in gastric biopsies. He believed that they played a role in gastric disease. Dr Marshall, a gastroenterology fellow, was attracted by the hypothesis and persuaded Dr Warren to make further investigations. They noted that, although the bacilli could not be classified by reference to Bergey's Manual of Determinative Bacteriology they resembled campylobacters more than spirochetes. By using microaerophilic campylobacter isolation techniques, Warren and Marshall achieved the first ever culture of the bacterium from human gastric biopsies in their 35th attempt in 1982. Because of a MRSA epidemic at the Royal Perth Hospital this H. pylori culture was not read until after the Eastern weekend (Kidd and Modlin 1998; Barry Marshall, personal communication 2005).