International Journal of Bacteriology

Volume 2014 (2014), Article ID 302192, 1 page

http://dx.doi.org/10.1155/2014/302192

Letter to the Editor

Mix Infections of Helicobacter pylori: A Major Risk Factor Affecting Genotyping Studies

Amin Talebi Bezmin Abadi1,2

¹Department of Medical Microbiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands

²Department of Bacteriology, School of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-111, Tehran, Iran

Received 7 May 2014; Accepted 28 May 2014; Published 5 June 2014

Academic Editor: Rodrigo E. Mendes

Copyright © 2014 Amin Talebi Bezmin Abadi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

We read with interest the paper “Evaluation of the pattern of EPIYA motifs in the Helicobacter pylori cagA gene of patients with gastritis and gastric adenocarcinoma from the Brazilian Amazon region ” in the volume 2014, 2014, issue of International Journal of Bacteriology [1]. In this paper, Vilar e Silva et al. [1] presented that EPIYA-C motif in the cagA gene was found linked with the development of intestinal metaplasia and gastric adenocarcinoma. Remarkably, the authors mentioned that they only used monoinfected subjects in this survey. As result, in this study, genomic DNA was extracted from the antral biopsy specimens using commercial kit, not from bacterial culture. Indeed, more than 5–10% of H. pylori cases are mix infections [2, 3]. Undeniably, having mix infections in H. pylori colonized persons is a kind of pitfall for all kinds of genotyping studies. That would be more reliable if authors extract DNA from bacterial culture rather than from biopsy specimen; subsequently, it is not exaggeration to say that the mix infections were almost ignored in this investigation. Interestingly, in this examination, authors found a significant association between EPIYA-C and occurrence of gastric adenocarcinoma among individuals with mix infections; ironically, we need to prove that those patients are mixed by several infections. Brazil as a country with high prevalence of H. pylori and H. pylori-induced diseases would be a novel area to investigate these critical virulence factors. Finally, we recommend the investigation of H. pylori EPIYA motifs among the strains isolated as single colony that surely result in trustful and reliable findings in the Brazilian population.

Conflict of Interests

The author declares that there is no conflict of interests regarding the publication of this paper.

References

A. Vilar e Silva, M. Ribeiro da Silva Jr., R. M. Dias Ferreira Vinagre, et al., “Evaluation of the pattern of EPIYA motifs in the Helicobacter pylori cagA gene of patients with gastritis and gastric adenocarcinoma from the Brazilian Amazon Region,” International Journal of Bacteriology, vol. 2014, Article ID 418063, 6 pages, 2014.

A. T. Bezmin Abadi and A. Mohabbati Mobarez, “High prevalence of Helicobacter pylori hopQ II genotype isolated from Iranian patients with gastroduodenal disorders,” Journal of Pathogens, vol. 2014, Article ID 842469, 4 pages, 2014.

J. G. Kusters, A. H. M. van Vliet, and E. J. Kuipers, “Pathogenesis of Helicobacter pylori infection,” Clinical Microbiology Reviews, vol. 19, no. 3, pp. 449–490, 2006.