Multiple Strain Colonization and Metronidazole Resistance in Helicobacter pylori-Infected Patients: Identification from Sequential and Multiple Biopsy Specimens

Jorgensen, Margaret; Daskalopoulos, George; Warburton, Verlaine; Mitchell, Hazel M.; Hazell, Stuart L.

doi:10.1093/infdis/174.3.631

Cited by 127 publications

(109 citation statements)

References 13 publications

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“…Infections with multiple H. pylori strains have been reported by many authors (16,21,23,35,38). Mixed infection was detected in 7.7% patients and was not related to age and disease.…”

Section: Discussionmentioning

confidence: 83%

iceA Genotypes of Helicobacter pylori Strains Isolated from Brazilian Children and Adults

et al. 2001

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Data concerning the geographic distribution of iceA alleles are scarce, and information on the association of the gene with the disease is rare and still controversial. Furthermore, no such study has been developed in Brazil, where duodenal ulcer and gastric adenocarcinoma are very common. We investigated, by PCR, the frequency of iceA alleles and cagA status in Helicobacter pylori strains isolated from 142 patients (62 children and 80 adults; 66 female; mean age, 30.0 years; age range, 3 to 78 years) with gastritis, duodenal ulcer, or gastric adenocarcinoma. iceA was identified in bacterium samples obtained from all patients. Eleven (7.7%) of them were infected with multiple strains. Among the patients with nonmixed infection, iceA2 allele was detected in 118 (90.1%). iceA2 allele was associated with ulcer (P ‫؍‬ 0.02) and with carcinoma (P ‫؍‬ 0.001). iceA2 amplicons of 229, 334, or 549 bp were detected, but none of them was associated with the patient's disorder. iceA2 strains were more frequent in patients older than 7 years (P ‫؍‬ 0.001). The gene was also more frequent in strains obtained from males (P ‫؍‬ 0.02). cagA was more common in strains obtained from carcinoma (P ‫؍‬ 0.0008) and ulcer patients (P < 0.006). cagA-positive strains were more frequent in children older than 7 years (P < 0.003). No association between cagA status and sex was found (P ‫؍‬ 0.28). In conclusion, we think iceA should not be used as a reliable marker for predicting the clinical outcome of H. pylori infection.

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“…Infections with multiple H. pylori strains have been reported by many authors (16,21,23,35,38). Mixed infection was detected in 7.7% patients and was not related to age and disease.…”

Section: Discussionmentioning

confidence: 83%

iceA Genotypes of Helicobacter pylori Strains Isolated from Brazilian Children and Adults

et al. 2001

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“…H. pylori strains may be diverse in infected patients. Previous studies showed that most patients were colonized with a mixed population of metronidazole-sensitive and -resistant H. pylori strains, and with one predominant strain accompanied by up to five variant strains at any one time (24). Metronidazole-based therapy may selectively enrich for meronidazole-resistant strains.…”

Section: Discussionmentioning

confidence: 99%

Helicobacter Pylori in Gastric Biopsies of Taiwanese Patients With Gastroduodenal Diseases

Lin

Chang²,

et al. 1998

JJMSB

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SUMMARY: This study was designed to study the in vivo prevalence and the heterogeneity of H, pylori in patients with gastroduodenal diseases in central Taiwan. H. pylori infection was detected in 74.1% (575/776) of the symptomatic population studied. The prevalence of H. pylori infection increased from 11.1% in those between the ages of one to 20, to 82.9% in those between the ages of 41 and 50, and to 84% in those between the ages of 51 and 60. There was no significant difference in the prevalence of H. pylori infection between men and women. Among different blood types, the prevalence and relative risk of H. pylori infection was significantly higher in blood group O patients (90.3%) than in blood group A (41%), blood group B (27.4%), or blood group AB (62%) patients. Metronidazole resistance was found in 6.7% of the primary isolates. The prevalence of metronidazole-resistant H. pylori strains was higher in women (7.69%) than in men (6.25%), but this difference was not significant. A total of 88% of H. pylori strains were cagA-positive. CagA gene-positive strains were present in 90.1% of duodenal ulcers, 90% of duodenal ulcers combined with gastric ulcer, 85.8% of gastric ulcers, and 69.2% of gastritis patients, and was significantly higher in peptic ulcer disease groups than in the gastritis group. In conclusion, there was a low incidence (6.7%) of metronidazole-resistant H. pylori strains and a high prevalence (88%) of H. pylori cagA -positive strains in central 13

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“…Evidence is emerging that cagA ϩ and cagA Ϫ organisms have differing life-styles in the hosts they colonize and in associations with disease (8). Increasing the complexity of mechanistic analysis are the observations that individuals may be simultaneously colonized by multiple H. pylori strains (29), that strains may change (clonal variation or "quasispecies" formation) over the course of colonization, and that horizontal gene transfer occurs among strains (30). Thus, no single isolate represents the gene pool of the total population with which a host has been colonized.…”

Section: The Modelmentioning

confidence: 99%

Ecology of Helicobacter pylori in the human stomach.

1997

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Multiple Strain Colonization and Metronidazole Resistance in Helicobacter pylori-Infected Patients: Identification from Sequential and Multiple Biopsy Specimens

Cited by 127 publications

References 13 publications

iceA Genotypes of Helicobacter pylori Strains Isolated from Brazilian Children and Adults

iceA Genotypes of Helicobacter pylori Strains Isolated from Brazilian Children and Adults

Helicobacter Pylori in Gastric Biopsies of Taiwanese Patients With Gastroduodenal Diseases

Ecology of Helicobacter pylori in the human stomach.

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