Journal of Antimicrobial Chemotherapy, Vol 40, 251-256, Copyright © 1997 by The British Society for Antimicrobial Chemotherapy
GG Stone, D Shortridge, RK Flamm, J Beyer, AT Ghoneim and SK Tanaka
A multi-country clinical trial was conducted in ten European countries to
determine the efficacy of clarithromycin-omeprazole dual therapy for
treating Helicobacter pylori infection in peptic ulcers. Gastric biopsies
were cultured for H. pylori before and after treatment. PCR- RFLP was used
to determine the genetic heterogeneity of 100 H. pylori isolates from
pretreatment and posttreatment biopsies. An 820 bp amplified fragment of
the ureC gene was digested with the restriction enzymes Sau3A and Hhal.
Fourteen different Sau3A patterns and 15 different Hhal patterns were
identified among the pretreatment isolates. In combination, 42 different
RFLP types were identified. Comparison of isolates before treatment with
those after treatment showed that five of ten patients on
clarithromycin-omeprazole dual therapy had the same RFLP type and that all
12 patients on omeprazole therapy alone had the same RFLP type. All
isolates were susceptible to clarithromycin prior to treatment, while seven
of ten patients on clarithromycin-omeprazole therapy had H. pylori that was
resistant to clarithromycin after therapy and 11 of 12 patients on
omeprazole therapy had isolates susceptible to clarithromycin after
treatment. In addition to PCR-RFLP typing, the presence of the
cytotoxin-associated gene (cagA) and the vacuolating gene (vacA) was
determined; 79% of the isolates were cagA-positive and all were
vacA-positive. The results of this study indicate that infection of H.
pylori in Europe is not restricted to a few RFLP types.
ORIGINAL ARTICLES
PCR-RFLP typing of ureC from Helicobacter pylori isolated from gastric biopsies during a European multi-country clinical trial
Anti-Infective Research Division, Abbott Laboratories, Abbott Park, IL 60064, USA. greg.stone@abbott.com
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