The dominance and pathogenicity of Helicobacter pylori in the gastric niche is eminent. Urease test is used to diagnose the infection of H. pylori. However, nowadays several reports indicated the emergence of organisms other than H. pylori (Non H. pylori bacteria– NHPs). We have reported urease positive, Ochrobactrum intermedium from the non-ulcer dyspeptic individual. Therefore such urease positive bacteria raise a question on the reliability of urease test. Since 2005, nearly 35 cases are reported for the presence of Ochrobactrum spp. from clinical specimens. Their high level of resistance to antibiotics and phylogenetic relationship to anthropozoonotic pathogen, Brucella makes them a probable human pathogen. Therefore, it is necessary to study their prevalence, survival mechanism and function in the human stomach. To check their pervasiveness in the Indian population, 218 urease positive gastric biopsy samples were processed and 62 Ochrobactrum spp. isolates were identified with and without H. pylori. Population study of Ochrobactrum spp. was also done using multilocus sequence typing (MLST) which revealed 45 sequence type and clonal population. As the prevalence of Ochrobactrum spp. is approx. 30 %, their survival mechanism was studied under in vitro gastric conditions (acidic pH, urea, microaerophilic environment), using microarray and RNA seq methods. The differential gene expression analysis showed 2 different acid resistance mechanism, i.e. Urease dependent acid resistance mechanism like H. pylori, and Amino acid dependent acid resistance mechanism. Our finding necessitates further detailed investigation of such NHPs in gastric environment and role of such bacteria in gastric niche and warrants further refinement of urease based diagnosis.

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