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

• Published in: The Journal of infectious diseases Vol. 174; no. 3; pp. 631 - 635
• Main Authors: Jorgensen, Margaret, Daskalopoulos, George, Warburton, Verlaine, Mitchell, Hazel M., Hazell, Stuart L.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-09-1996; University of Chicago Press; Oxford University Press
• Subjects: Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Biopsies; Biopsy; Bismuth; Concise Communications; DNA; DNA, Bacterial - analysis; Drug Resistance, Microbial - genetics; Genetic polymorphism; Genetic Variation; Genomics; Helicobacter Infections - drug therapy; Helicobacter pylori; Helicobacter pylori - genetics; Helicobacter pylori - growth & development; Human bacterial diseases; Humans; Infections; Infectious diseases; Medical sciences; Metronidazole - therapeutic use; Microbial colonization; Polymerase Chain Reaction; Stomach; Stomach - microbiology; Human; Imidazole derivatives; Spirillales; Spirillaceae; Biodiversity; Infection; Campylobacter infection; Microbiological investigation; Helicobacter pylori; Biopsy; Multiple resistance; Pathogen strain; Bacteriosis; Bacteria
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/174.3.631

Helicobacter pylori strain diversity was investigated in infected persons by collection of multiple biopsies before and after therapy failure. It was demonstrated by random amplification of polymorphic DNA polymerase chain reaction that patients may be infected with a mixed population of H. pylori strains. Most patients were colonized with a predominant strain accompanied by up to 5 variant strains. The use of antimicrobials resulted in an altered distribution of the strains present, but the predominant strain usually remained. Patients may be infected with a mixed population of metronidazole-sensitive and -resistant strains at one time, with metronidazole-based therapy selectively enriching for a resistant population.