Polycolonization of Helicobacter pylori among Chinese subjects

• Published in: Clinical microbiology and infection Vol. 7; no. 4; pp. 187 - 192
• Main Authors: Yakoob, J., Fan, X.-G., Hu, G.-L., Yang, H.-X., Liu, L., Liu, S.-H., Tan, D.-M., Li, T.-G., Zhang, Z.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Elsevier Ltd 01.04.2001; Blackwell Science Ltd; Blackwell; Elsevier Limited
• Subjects: Adult; Anti-Bacterial Agents - pharmacology; antibiotic susceptibility test; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; China; Clarithromycin - pharmacology; DNA heterogeneity; Drug Resistance, Microbial; Electrophoresis, Polyacrylamide Gel; Female; Genetic Variation; Helicobacter Infections - diagnosis; Helicobacter Infections - microbiology; Helicobacter pylori; Helicobacter pylori - classification; Helicobacter pylori - drug effects; Helicobacter pylori - genetics; Helicobacter pylori - isolation & purification; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Metronidazole - pharmacology; Microbial Sensitivity Tests; Middle Aged; multiple strain colonization; Polymerase Chain Reaction; Stomach - microbiology; Asia; China; Helicobacter pylori; DNA heterogeneity; antibiotic susceptibility test; multiple strain colonization; Human; Nitro compound; Stomach; Imidazole derivatives; Clarithromycin; Mixed infection; Spirillales; Drug susceptibility test; Spirillaceae; Macrolide; Infection; Microbiological investigation; Bacteriosis; Digestive diseases; Bacteria; Metronidazole; Antibacterial agent; Clinical isolate; Gastric disease
• ISSN: 1198-743X; 1469-0691
• DOI: 10.1046/j.1198-743x.2001.00226.x

Objective To investigate the situation among Chinese patients with regard to infection with multiple strains of Helicobacter pylori. Methods Biopsy specimens for culture of H. pylori were obtained from gastric antrum, body and fundus of 20 patients during endoscopic investigation of upper gastrointestinal symptoms. H. pylori was identified by culture from one site in 16 and two or more sites in 10 of the 16 patients. Five isolated colonies of six strains of H. pylori from gastric antrum were subcultured and used for further analysis. Antibiotic susceptibility to metronidazole and clarithromycin was determined by disk diffusion test. Protein profiles of isolates were compared by sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE). DNA diversity of the isolates was determined by arbitrarily primed polymerase chain reaction (AP-PCR) fingerprinting. Results Of the 10 patients with multiple isolates, 70% (7/10) exhibited variation in susceptibility to metronidazole and 20% (2/10) to clarithromycin between different sites. In 83% of (5/6) single colonies, no variability was seen in metronidazole and clarithromycin susceptibility; they were either susceptible or resistant. Protein profiles of all isolates by SDS-PAGE were similar. Isolates from different patients produced clearly different AP-PCR fingerprints. In 50% of H. pylori strains isolated from different sites of the stomach, genetic diversity was demonstrated by different AP-PCR fingerprints. In 67% (4/6) strains, five single-colony fingerprints were similar. Conclusions Genetic variability has been found in H. pylori strains. Individual patients are infected with a single predominant genotype at a single site but can be colonized by multiple strains, and they may show different antibiotic susceptibilities. Individual colonies of the H. pylori population from a single site may not always yield identical DNA fingerprints and antibiotic sensitivities.