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Journal of Clinical Microbiology, December 2008, p. 3912-3918, Vol. 46, No. 12
0095-1137/08/$08.00+0     doi:10.1128/JCM.01453-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

DNA-Level Diversity and Relatedness of Helicobacter pylori Strains in Shantytown Families in Peru and Transmission in a Developing-Country Setting{triangledown}

Phabiola M. Herrera,1,2 Melissa Mendez,1,2,4 Billie Velapatiõ,1,2 Livia Santivaez,1,2,4 Jacqueline Balqui,1,2 S. Alison Finger,1,4 Jonathan Sherman,1 Mirko Zimic,1 Lilia Cabrera,2 Jose Watanabe,5 Carlos Rodríguez,5 Robert H. Gilman,1,2,3* and Douglas E. Berg4,6*

Laboratorios de Investigación y Desarrollo, Facultad de Ciencias, Universidad Peruana Cayetano Heredia, Lima, Peru,1 Asociacion Benefica PRISMA, Lima, Peru,2 Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,3 Departments of Molecular Microbiology,4 Genetics and Medicine, Washington University School of Medicine, St. Louis, Missouri,6 Policlinico Peruano Japones, Lima, Peru5

Received 29 July 2008/ Returned for modification 23 September 2008/ Accepted 30 September 2008

The efficiency of transmission of a pathogen within families compared with that between unrelated persons can affect both the strategies needed to control or eradicate infection and how the pathogen evolves. In industrialized countries, most cases of transmission of the gastric pathogen Helicobacter pylori seems to be from mother to child. An alternative model, potentially applicable among the very poor in developing countries, where infection is more common and the sanitary infrastructure is often deficient, invokes frequent transmission among unrelated persons, often via environmental sources. In the present study, we compared the genotypes of H. pylori from members of shantytown households in Peru to better understand the transmission of H. pylori in developing-country settings. H. pylori cultures and/or DNAs were obtained with informed consent by the string test (a minimally invasive alternative to endoscopy) from at least one child and one parent from each of 62 families. The random amplified polymorphic DNA fingerprints of 57 of 81 (70%) child-mother strain pairs did not match, nor did the diagnostic gene sequences (>1% DNA sequence difference), independent of the child's age (range, 1 to 39 years). Most strains from siblings or other paired family members were also unrelated. These results suggest that H. pylori infections are often community acquired in the society studied. Transmission between unrelated persons should facilitate the formation of novel recombinant genotypes by interstrain DNA transfer and selection for genotypes that are well suited for individual hosts. It also implies that the effective prevention of H. pylori infection and associated gastroduodenal disease will require anti-H. pylori measures to be applied communitywide.

* Corresponding author. Mailing address for Douglas E. Berg: Department of Molecular Microbiology, Campus Box 8230, Washington University Medical School, 4940 Parkview Place, St. Louis, MO 63110. Phone: (314) 362-2772. Fax: (314) 362-1232. E-mail: berg{at}borcim.wustl.edu. Mailing address for Robert H. Gilman: The Johns Hopkins School of Public Health, Department of International Health, 615 N. Wolfe St., Baltimore, MD 21205. Phone: (410) 614-3959. Fax: (410) 614-6060. E-mail: rgilman{at}jhsph.edu

{triangledown} Published ahead of print on 8 October 2008.

Journal of Clinical Microbiology, December 2008, p. 3912-3918, Vol. 46, No. 12
0095-1137/08/$08.00+0     doi:10.1128/JCM.01453-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.





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