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Journal of Clinical Microbiology, December 1999, p. 4071-4080, Vol. 37, No. 12
Laboratoire de Microbiologie A, CHU La
Milétrie, 86021 Poitiers, France
Received 19 February 1999/Returned for modification 15 June
1999/Accepted 20 September 1999
Typing systems are used to discriminate between isolates of
Helicobacter pylori for epidemiological and clinical
purposes. Discriminatory power and typeability are important
performance criteria of typing systems. Discriminatory power refers to
the ability to differentiate among unrelated isolates; it is
quantitatively expressed by the discriminatory index (DI).
Typeability refers to the ability of the method to provide an
unambiguous result for each isolate analyzed; it is quantitatively
expressed by the percentage of typeable isolates. We evaluated the
discriminatory power and the typeability of the most currently used DNA
fingerprinting methods for the typing of H. pylori
isolates: ribotyping, PCR-based restriction fragment length
polymorphism (PCR-RFLP) analysis, and random amplified
polymorphism DNA (RAPD) analysis. Forty epidemiologically unrelated clinical isolates were selected to constitute a test population adapted to the evaluation of these performance
criteria. A meta-analysis of typeability and discriminatory power was
conducted retrospectively with raw data from published studies in which ribotyping, PCR-RFLP, RAPD, repetitive extragenic palindromic DNA
sequence-based PCR (REP-PCR), or pulsed-field gel electrophoresis (PFGE) was used. Experimental results and the meta-analysis
demonstrated the optimal typeability (100%) and the excellent
discriminatory powers of PCR-based typing methods: RAPD
analysis, DIs, 0.99 to 1; REP-PCR, DI, 0.99; and PCR-RFLP analysis,
DIs, 0.70 to 0.97). Chromosome restriction-based typing methods
(ribotyping and PFGE) are limited by a low typeability (12.5 to 75%)
that strongly decreases their discriminatory powers: ribotyping, DI,
0.92; PFGE, DIs, 0.24 to 0.88. We do not recommend the use of
ribotyping and PFGE for the typing of H. pylori isolates.
We recommend the use of PCR-based methods.
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Performance Criteria of DNA Fingerprinting Methods for Typing
of Helicobacter pylori Isolates: Experimental
Results and Meta-Analysis
*
Corresponding author. Mailing address: Laboratoire de
Microbiologie A, CHU La Milétrie, BP 577, 86021 Poitiers, France.
Phone: (00-33) 549443889. Fax: (00-33) 549443888. E-mail:
c.burucoa{at}chu-poitiers.fr.
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