High frequency variations of Helicobacter pylori isolates in individual hosts in a Chinese population

Background: Colonization of individual hosts by multiple Helicobacter pylori genotypes may be one reason why this infection is persistent and difficult to eradicate. Methods: In order to study the diversity of H. pylori in individuals, a modified randomly amplified polymorphic DNA (RAPD) method was applied using primary culture isolates instead of passaged cultures. Results: The results showed that variations in H. pylori were prevalent among individuals in the Chinese population, and the incidence of multiple colonization was 99.1% (115/116), significantly higher than in other reports. Moreover, the number of RAPD genotypes was found to be significantly associated with the process of disease development (p< 0.05). Indeed, a trend for a higher number of RAPD genotypes within a single host (up to five genotypes) was observed as the disease developed or became more serious. After subculturing for three generations in our experiment, some genotypes present in the primary cultures were lost. The different genotypes in one patient may have originated from a single ancestral strain, as determined by analysis of six H. pylori housekeeping gene alleles, most of which were shown to be identical. Conclusions: These results suggest that investigating isolates of the primary culture will better reflect the H. pylori diversity in individuals. Also, they indicate that continuous variation of one strain in the gastric microenvironment may be the main cause of H. pylori diversity in individuals in the Chinese population.