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Journal of Clinical Microbiology, April 2004, p. 1648-1651, Vol. 42, No. 4
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.4.1648-1651.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Analysis of Helicobacter pylori Genotypes and Correlation with Clinical Outcome in Turkey

Huseyin Saribasak,¹ Barik A. Salih,^1* Yoshio Yamaoka,² and Ersan Sander³

Fatih University, Faculty of Science, Department of Biology/Microbiology Unit,¹ Department of Gastroenterology, SSK Samatya Hospital Istanbul, Turkey,³ Department of Medicine, Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas 77030²

Received 12 December 2003/ Returned for modification 23 December 2003/ Accepted 21 January 2004

The predominant Helicobacter pylori strains circulating among geographic locations differ in regard to genomic structure. The association of the cagA-positive, vacA s1 genotypes with peptic ulcer disease (PUD) and gastric cancer was reported in Western countries but not in East Asian countries. Strains from Western countries predominantly possessed cagA type 2a, vacA s1a or s1b/m1a, or vacA m2a genotypes, whereas strains from East Asia possessed cagA type 1a, vacA s1c/m1b, or vacA m2b genotypes. Whether the Turkish strains possessed such genotypes was investigated and correlated with the disease outcome. Seventy-three patients from Turkey were enrolled. H. pylori was detected in 65 (89%) patients (22 with gastritis, 33 with PUD, and 10 with gastric cancer) by any of the following tests: Campylobacter-like organism test, culture, or PCR. Among the H. pylori-positive patients, presence of the cagA gene (78%) was significantly associated with PUD (P < 0.00001), gastric cancer (P < 0.001), and vacA s1a genotypes (P < 0.0001). Multiple vacA genotypes were more prevalent in PUD and gastric cancer patients than in patients with gastritis. Restriction fragment length polymorphism analysis of the cagA gene revealed three different patterns with no significant association with clinical outcome. Turkish strains examined predominantly possessed cagA type 2a, vacA s1a/m1a, or vacA m2a genotypes, which were typical genotypes in strains from Western countries. This fact might be one of the reasons for the low prevalence of severe gastroduodenal diseases in Turkey compared to the East Asian countries.

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* Corresponding author. Mailing address: Department of Biology/Microbiology Unit, Faculty of Science, Fatih University, B. cekmece, Istanbul, Turkey. Phone: 90 212 889 0810, ext. 1041. Fax: 90 212 889 0832. E-mail: basalih{at}fatih.edu.tr.

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Journal of Clinical Microbiology, April 2004, p. 1648-1651, Vol. 42, No. 4
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.4.1648-1651.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

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