title: Mixed Infections ofHelicobacter pyloriIsolated from Patients with Gastrointestinal Diseases in Taiwan.
abstract: Background. PersistentHelicobacter pyloriinfection may induce several upper gastrointestinal diseases. Two major virulence factors ofH. pylori, vacuolating cytotoxin A (VacA) and cytotoxin-associated gene A (CagA), are thought to be associated with the severity of disease progression. The distribution ofvacAandcag-pathogenicity island (cag-PAI) alleles varies inH. pyloriisolated from patients in different geographic regions.Aim. To assess the association between mixed infection ofH. pyloriclinical isolates from Taiwanese patients and the severity of gastrointestinal diseases.Methods. A total of 70 patients were enrolled in this study. Six distinct and well-separated colonies were isolated from each patient and 420 colonies were analyzed to determine the genotypes of virulence genes.Results. The prevalence of mixed infections of allH. pylori-infected patients was 28.6% (20/70). The rate of mixed infections in patients with duodenal ulcer (47.6%) was much higher than that with other gastrointestinal diseases (P< 0.05).Conclusions.H. pylorimixed infections show high genetic diversity that may enhance bacterial adaptation to the hostile environment of the stomach and contribute to disease development.
authors.affiliation: Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Taoyuan, Taiwan; Graduate Institute of Basic Medical Science, School of Medicine, China Medical University, Taichung, Taiwan; Department of Medical Research and Department of Laboratory Medicine, China Medical University and Hospital, Taichung, Taiwan; Department of Nursing, Asia University, Taichung, Taiwan.
authors.forename: Chih-Ho
authors.identifier: 0000-0001-9229-818X
authors.initials: CH
authors.lastname: Lai
authors.affiliation: Graduate Institute of Basic Medical Science, School of Medicine, China Medical University, Taichung, Taiwan; Department of Medical Research and Department of Laboratory Medicine, China Medical University and Hospital, Taichung, Taiwan.
authors.forename: Ju-Chun
authors.initials: JC
authors.lastname: Huang
authors.affiliation: Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Chuan
authors.initials: C
authors.lastname: Chiang-Ni
authors.affiliation: Graduate Institute of Basic Medical Science, School of Medicine, China Medical University, Taichung, Taiwan; Rheumatology Research Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Ju-Pi
authors.initials: JP
authors.lastname: Li
authors.affiliation: Graduate Institute of Basic Medical Science, School of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Lii-Tzu
authors.initials: LT
authors.lastname: Wu
authors.affiliation: Department of Medical Research and Department of Laboratory Medicine, China Medical University and Hospital, Taichung, Taiwan; Department of Nursing, Asia University, Taichung, Taiwan.
authors.forename: Hua-Shan
authors.initials: HS
authors.lastname: Wu
authors.affiliation: Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Sun
authors.affiliation: Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Mei-Ling
authors.initials: ML
authors.lastname: Lin
authors.affiliation: Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Ju-Fang
authors.initials: JF
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Shuang-Ho Hospital, New Taipei, Taiwan.
authors.forename: Hwai-Jeng
authors.identifier: 0000-0002-8175-3893
authors.initials: HJ
authors.lastname: Lin