Impact of virulence markers on clinical outcomes in adult populations.

BACKGROUND

In recent years, associations between specific virulence markers of () and gastrointestinal disorders have been suggested.

AIM

To investigate the presence of virulence factors including vacuolating cytotoxin A genotypes (, , , and ), cytotoxin-associated gene A (A), and urease activity in strains isolated from Arab and Jewish populations in northern Israel and to assess associations between these factors and patients' demographics and clinical outcomes.

METHODS

Patients ( = 108) who underwent gastroscopy at the Baruch Padeh Medical Center, Poriya due to symptomatic gastroduodenal pathologies as part of diagnosis were enrolled in the study. Gastric biopsy specimens were collected from the antrum of the stomach. Clinical condition was assessed by clinical pathology tests. Bacteria were isolated on modified BD Helicobacter Agar (BD Diagnostics, Sparks, MD, United States). Bacterial DNA was extracted, and PCR was performed to detect A and vacuolating cytotoxin A genes. Urease activity was assessed using a rapid urease test.

RESULTS

A significant correlation was found between disease severity and patient ethnicity ( = 0.002). A significant correlation was found between A presence and the genotype ( = 0.02), which is considered the most virulent genotype. Further, a higher level of urease activity was associated with isolates originating from the Jewish population. Moreover, higher urease activity levels were measured among A-/ and A-/ isolates.

CONCLUSION

Our study highlights the importance of incorporating molecular methods for detection of virulence markers of in order to tailor optimal treatments for each patient. Further investigation should be performed regarding associations between virulence factors and ethnicity.