title: Helicobacter pylori: clonal population structure and restricted transmission within families revealed by molecular typing.
abstract: Helicobacter pylori infects up to 50% of the human population worldwide. The infection occurs predominantly in childhood and persists for decades or a lifetime. H. pylori is believed to be transmitted from person to person. However, tremendous genetic diversity has been reported for these bacteria. In order to gain insight into the epidemiological basis of this phenomenon, we performed molecular typing of H. pylori isolates from different families. Fifty-nine H. pylori isolates from 27 members of nine families were characterized by using restriction fragment length polymorphism analysis of five PCR-amplified genes, by pulsed-field gel electrophoresis (PFGE) of chromosomal DNA, and by vacA and cagA genotyping. The 16S rRNA gene exhibited little allelic variation, as expected for a unique bacterial species. In contrast, the vacA, flaA, ureAB, and lspA-glmM genes were highly polymorphic, with a mean genetic diversity of 0.83, which exceeds the levels recorded for all other bacterial species. In conjunction with PFGE, 59 H. pylori isolates could be differentiated into 21 clonal types. Each individual harbored only one clone, occasionally with a clonal variant. Identical strains were always found either between siblings or between a mother and her children. Statistical analysis revealed clonality of population structure in all isolates. The results of this study suggest the possible coexistence of a large array of clonal lineages that are evolving in each individual in isolation from one another. Transmission appears to occur primarily from mother to child and perhaps between siblings.
authors.affiliation: Department of Medical Microbiology, Johannes Gutenberg University, D-55101 Mainz, Germany.
authors.forename: S R
authors.initials: SR
authors.lastname: Han
authors.forename: H C
authors.initials: HC
authors.lastname: Zschausch
authors.forename: H G
authors.initials: HG
authors.lastname: Meyer
authors.forename: T
authors.initials: T
authors.lastname: Schneider
authors.forename: M
authors.initials: M
authors.lastname: Loos
authors.forename: S
authors.initials: S
authors.lastname: Bhakdi
authors.forename: M J
authors.initials: MJ
authors.lastname: Maeurer
mesh_terms: D000942:Antigens, Bacterial; D001426:Bacterial Proteins / Q000235:genetics; D015373:Bacterial Typing Techniques; D002648:Child; D004247:DNA / Q000235:genetics; D018562:Disease Transmission, Infectious; D016521:Electrophoresis, Gel, Pulsed-Field; D005190:Family; D005838:Genotype; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission*; D016480:Helicobacter pylori / Q000145:classification / Q000235:genetics; D006801:Humans; D010802:Phylogeny; D016133:Polymerase Chain Reaction / Q000379:methods; D012150:Polymorphism, Restriction Fragment Length; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D021521:Ribotyping
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D012336:RNA, Ribosomal, 16S; C074689:VacA protein, Helicobacter pylori; C080866:cagA protein, Helicobacter pylori; D004247:DNA