Cellini Luigina, Grande Rossella, Di Campli Emanuela, Di Bartolomeo Soraya, Capodicasa Simona, Marzio Leonardo
Department of Biomedical Sciences, University "G. d'Annunzio", Chieti, Italy.
Scand J Gastroenterol. 2006 Mar;41(3):280-7. doi: 10.1080/00365520510024223.
To assess the relationship between the presence of mixed infection of Helicobacter pylori and both antimicrobial susceptibility and virulence markers.
Thirty-six patients with H. pylori infection were included in the study. Three colonies were selected from each positive biopsy sample collected from each host for a total of 108 H. pylori strains. The genetic variability was evaluated through the amplified fragment length polymorphism (AFLP) analysis; the antibiotic susceptibility to amoxicillin, clarithromycin, moxifloxacin, rifabutin and tinidazole was determined using the minimum inhibitory concentrations (MICs) with the agar dilution method. Moreover, the vacA, cagA, iceA and babA2 statuse were detected by polymerase chain reaction (PCR).
There was a strong connection between mixed H. pylori infection and antimicrobial resistance. In particular, H. pylori strains with genetic variability, in the same host, expressed more resistance to clarithromycin, moxifloxacin and tinidazole than that expressed in strains with a unique genetic host pattern. VacA s1m1/s1m2 genotypes were found in 70% of strains isolated in mixed infection, whereas the same allelic combinations were found in 42% of strains, isolated in single infection. The cagA(+) status prevailed both in patients with mixed (97%) and in those with single infection (85%) without significant differences. The iceA1 status was more commonly found in patients with mixed infection, whereas the babA2 status was significantly prevalent in single H. pylori infection.
Mixed H. pylori infection harbouring in one patient is significantly related to strains that are more resistant to antibiotics and with a more virulent genotype (vacA s1m1/s1m2, cagA, iceA1) than strains responsible for single infection.
评估幽门螺杆菌混合感染与抗菌药敏性及毒力标志物之间的关系。
本研究纳入36例幽门螺杆菌感染患者。从每个宿主采集的每份阳性活检样本中选取3个菌落，共获得108株幽门螺杆菌菌株。通过扩增片段长度多态性（AFLP）分析评估基因变异性；采用琼脂稀释法测定阿莫西林、克拉霉素、莫西沙星、利福布汀和替硝唑的最低抑菌浓度（MIC）以确定抗生素敏感性。此外，通过聚合酶链反应（PCR）检测vacA、cagA、iceA和babA2状态。
幽门螺杆菌混合感染与抗菌耐药性之间存在密切联系。特别是，同一宿主中具有基因变异性的幽门螺杆菌菌株对克拉霉素、莫西沙星和替硝唑的耐药性高于具有单一基因宿主模式的菌株。在混合感染中分离出的菌株中，70%发现VacA s1m1/s1m2基因型，而在单一感染中分离出的菌株中该等位基因组合为42%。cagA(+)状态在混合感染患者（97%）和单一感染患者（85%）中均占主导，无显著差异。iceA1状态在混合感染患者中更常见，而babA2状态在单一幽门螺杆菌感染中显著更普遍。
与单一感染的菌株相比，一名患者体内的幽门螺杆菌混合感染与对抗生素耐药性更强且具有更强毒力基因型（vacA s1m1/s1m2、cagA、iceA1）的菌株显著相关。
