VIRULENCE PROFILE OF HELICOBACTER PYLORI DETECTED IN GASTRIC BIOPSIES OF PATIENTS UNDERGOING ENDOSCOPY IN UPPER EGYPT

Abstract

Background: Helicobacter pylori (H. pylori) is a common cause of gastric ulcers and is a risk factor for gastric carcinoma. Little data are available about the characters of H. pylori causing infections in patients from Upper Egypt. Therefore, the aim of this study was to investigate the frequency of H. pylori infection in Egyptian patients undergoing endoscopy and complaining of persistent upper gastrointestinal symptoms directly in biopsy specimens using PCR technique and to study the associated virulence-related genes in H. pylori positive samples. Materials and Methods: One hundred and twenty gastric biopsy specimens were collected from Egyptian patients admitted to Assiut University Hospital and complaining of persistent upper gastrointestinal symptoms. H. pylori DNA was extracted for molecular identification by PCR. Positive samples were further analyzed to investigate the presence of different virulence-related genes and gene combinations. Results: H. pylori was detected in 92/120 (76.6%) of collected biopsies. All strains carried the vacA s1 subtype. The prevalence of the virulence genes cagA, cagE, iceA1, iceA2 and oipA were 79 (84.8%), 41(44.5%), 69 (75%), 44 (47.8%), and 55(59.7%) of the H. pylori positive samples, respectively. Genetic analysis showed that H. pylori were grouped into 29 different genotype combinations. The s1/m1/i1/d1/c1/cagA/iceA1/oipA genotype was the most predominant. Conclusion: Our results show a high frequency of H. pylori infections among Egyptian patients with gastrointestinal symptoms. The s1/m1/i1 vacA hybrid is the most prevalent subtype. The distribution of the different virulence-related genes shows alarming rates of cagA, cagE, iceA1, iceA2 and oipA. Careful monitory of H. pylori infections and investigation of their genetic characters should be carried out to control the spread of the virulent strains.