title: Using macro-arrays to study routes of infection of Helicobacter pylori in three families.
abstract: BACKGROUND
  Analysis of the evolutionary dynamics of Helicobacter pylori allowed tracing the spread of infection through populations on different continents but transmission pathways between individual humans have not been clearly described.
  
  
  METHODS
  To investigate person-to-person transmission, we studied three families each including one child with persistence of symptoms after antibiotic treatment. Ten isolates from the antrum and corpus of stomach of each family member were analyzed both by sequencing of two housekeeping genes and macroarray tests.
  
  
  RESULTS
  A total of 134 (8.4%) out of the 1590 coding sequences (CDSs) tested, including cag PAI and insertion sequences, were present in some but not all isolates (and are therefore defined as variable CDSs). Most of the variable CDSs encoded proteins of unknown function (76/134) or were selfish DNA including that encoding restriction/modification enzymes (13/134). Isolates colonizing the stomach of one individual can vary by point mutations, as seen in hspA, or by the gain or loss of one to five CDSs. They were considered as (genetic) variants. The phylogenetic clustering of gene profiles obtained on macro-arrays allowed identifying the different strains infecting families. Two to five strains circulated within a family. Identical strains were present in at least two members of all three families supporting the accepted model of intrafamilial transmission. Surprisingly, the mother was not implicated in the transmission of H. pylori in the two French families. Sibling-to-sibling transmission and acquisition of H. pylori from outside the family appeared to be probable in the transmission pathways.
  
  
  CONCLUSIONS
  Macroarray analysis based on previously selected CDSs gives a comprehensive view of the genome diversity of a pathogen. This approach combined with information on the origin of the hspA and glmM alleles revealed that Helicobacter pylori infection may be acquired by more diverse routes than previously expected.
authors.affiliation: Service de Bactériologie, Université Paris V, Hôpital Cochin, Paris, France. j.raymond@svp.aphp.fr
authors.forename: Josette
authors.initials: J
authors.lastname: Raymond
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Thiberge
authors.forename: Nicolas
authors.initials: N
authors.lastname: Kalach
authors.forename: Michel
authors.initials: M
authors.lastname: Bergeret
authors.forename: Christophe
authors.initials: C
authors.lastname: Dupont
authors.forename: Agnès
authors.initials: A
authors.lastname: Labigne
authors.forename: Catherine
authors.initials: C
authors.lastname: Dauga
mesh_terms: D018562:Disease Transmission, Infectious; D005190:Family; D005260:Female; D005798:Genes, Bacterial; D016481:Helicobacter Infections / Q000635:transmission*; D016480:Helicobacter pylori / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D013045:Species Specificity