Antibiotic Resistance and Genotypes of Helicobacter pylori Strains in Patients with Gastroduodenal Disease in Southeast Poland

Abstract

The aim of this study was to investigate genetic diversity of <i>Helicobacter pylori</i> virulence markers to predict clinical outcome as well as to determine an antibiotic susceptibility of <i>H. pylori</i> strains in Poland. Gastric biopsies from 132 patients with gastrointestinal disorders were tested for presence of <i>H. pylori</i> with the use of rapid urease test, microbial culture, and polymerase chain reaction (PCR) detection. The genetic diversity of 62 <i>H. pylori</i> positive samples was evaluated by detection of <i>cagA</i> and PCR-typing of <i>vacA</i> and <i>iceA</i> virulence-associated genes. Most common <i>H. pylori</i> genotypes were <i>cagA</i>(+)<i>vacAs1m2</i> (27.4%) and <i>cagA</i>(-)<i>vacAs2m2</i> (24.2%). In logistic regression analysis, we recognized the subsequent significant associations: gastritis with <i>ureC</i>, i.e., <i>H. pylori</i> infection (<i>p</i> = 0.006), BMI index (<i>p</i> = 0.032); and negatively with <i>iceA1</i> (<i>p</i> = 0.049) and peptic ulcer with <i>cagA</i> (<i>p</i> = 0.018). Thirty-five <i>H. pylori</i> strains were cultured and tested by E-test method showing that 49% of strains were resistant to at least one of the tested antibiotics. This is the first study that reports the high incidence and diversity of allelic combination of virulence genes in gastroduodenitis patients in Poland. Genotyping of <i>H. pylori</i> strains confirmed the involvement of <i>cagA</i> gene and <i>vacAs1m1</i> genotype in development and severity of gastric disorder.