title: Polycolonization of Helicobacter pylori among Chinese subjects.
abstract: 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.
authors: Department of Infectious Diseases, Xiangya Hospital, Hunan Medical University, Changsha, Hunan, P.R. China. yakoobjaved@hotmail.com
authors: J
authors: J
authors: Yakoob
authors: X G
authors: XG
authors: Fan
authors: G L
authors: GL
authors: Hu
authors: H X
authors: HX
authors: Yang
authors: L
authors: L
authors: Liu
authors: S H
authors: SH
authors: Liu
authors: D M
authors: DM
authors: Tan
authors: T G
authors: TG
authors: Li
authors: Z
authors: Z
authors: Zhang
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002681:China; D017291:Clarithromycin / Q000494:pharmacology; D004352:Drug Resistance, Microbial; D004591:Electrophoresis, Polyacrylamide Gel; D005260:Female; D014644:Genetic Variation; D016481:Helicobacter Infections / Q000175:diagnosis / Q000382:microbiology*; D016480:Helicobacter pylori / Q000145:classification* / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D013270:Stomach / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D017291:Clarithromycin