Abstract
BackgroundIndividuals can be infected with multiple strains of Helicobacter pylori. However, the differences among co-infecting strains have not been well analyzed yet. This study aimed to investigate whether the virulence factors and antibiotic resistance patterns of H. pylori differ between strains isolated from different locations of the stomach in the same patient.MethodsH. pylori isolates were obtained from the antrum and body of the stomach. Genetic differences were examined by random amplified polymorphic DNA (RAPD) fingerprinting. Antibiotic resistance was assessed using the agar dilution method. Virulence factors were identified by polymerase chain reaction and DNA sequencing.ResultsAmong 80 patients, co-infection by two H. pylori strains was detected in 10 patients. Among the 10 pairs of H. pylori strains, differences in antibiotic resistance patterns were detected in 7 pairs (clarithromycin, 1 patient; quinolone, 3 patients; metronidazole, 4 patients) and differences in virulence factors were detected in 5 pairs. The cagA virulence gene was detected in all 10 patients, and 2 patients had H. pylori strains with different EPIYA motifs. Differences in vacA genotypes were detected in 4 patients.ConclusionsCo-infection by two H. pylori strains was confirmed by RAPD fingerprinting. Frequently, two H. pylori strains obtained from a single host differed in their virulence factors and antibiotic resistance patterns. Co-infection by multiple H. pylori strains could undermine the success of eradication therapy and should be considered when interpreting the results of antimicrobial susceptibility tests.
Highlights
Individuals can be infected with multiple strains of Helicobacter pylori
random amplified polymorphic DNA (RAPD) fingerprinting and clinical information Among 80 patients with successful H. pylori isolation from the antrum and body of the stomach, the co-existence of different H. pylori strains was detected in 10 patients by RAPD fingerprinting of H. pylori (Fig. 1)
These results suggest that co-infecting H. pylori strains frequently have different antibiotic resistance patterns as well as different virulence factors
Summary
Individuals can be infected with multiple strains of Helicobacter pylori. the differences among co-infecting strains have not been well analyzed yet. This study aimed to investigate whether the virulence factors and antibiotic resistance patterns of H. pylori differ between strains isolated from different locations of the stomach in the same patient. H. pylori is a major cause of gastric and duodenal diseases, and it has been estimated to currently infect half of the world’s population [1, 2]. Multiple H. pylori strains isolated from the same host might differ in certain characteristics such as their virulence factors or antibiotic resistance patterns. Such co-infections could affect the success of eradication therapy, thereby influencing the treatment course and prognosis of patients with H. pylori infection. The differences among H. pylori strains obtained from the same host in terms of their characteristics have not been well investigated yet
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