| Sumario: | Background: Helicobacter pylori colonization results in site‐specific disorders of the upper digestive tract, such as inflammatory, ulcerative and neoplastic lesions. The development of these disorders is related to the virulence genes carried by the bacterium. This study is aimed at identifying the different virulence genes of H. pylori strains from Cameroon, as well as their association with clinical outcomes. Methods: A total of 138 H. pylori urease‐positive biopsy samples were used in this study. They were collected from patients that underwent an upper gastrointestinal endoscopy for the investigation of dyspepsia in health facilities in Cameroon. The alterations of the gastric mucosa were recorded during the endoscopic procedure. PCR confirmation of H. pylori in biopsy samples was performed, followed by the identification of vacA, cagA, IceA and DupA virulence genes. The results were analysed using the SPSS software Version 22. Results: Seventy‐eight out of the 138 biopsy samples were PCR confirmed as H. pylori positive. VacAs1, vacAm1, vacAs1m1 and vacAm2 were identified in 88.5%, 83.3%, 82.1% and 1.3% of H. pylori strains, respectively, while the vacAs2 genotype was absent. The prevalence of cagA, DupA, IceA1 and IceA2 was 66.7%, 27.4%, 25.7% and 57.5%, respectively, whereas vacAs1m1 and cagA (64.9%) were the most frequent combination. Strains harbouring IceA1 (p = 0.039), IceA1 and vacAs1m1 (p = 0.008) and IceA1 and cagA (p = 0.042) genotype were significantly associated with gastric inflammatory lesions, while those harbouring IceA1 (p = 0.032), vacAs1m1 and IceA1 (p = 0.016), cagA and IceA1 (p = 0.029) and DupA and IceA1 (p = 0.044) genotype were significantly associated with ulcerated lesions. Conclusion: Our data showed a higher prevalence of vacAs1, vacAm1, vacAs1m1, cagA and IceA2 genotype, lower prevalence of DupA and IceA1, absence of vacAs2 and vacAs1m1 and cagA as the most frequent genotype combination among H. pylori strains circulating in Cameroon. Strains harbouring IceA1, IceA1 and vacAs1m1, IceA1 and cagA and IceA1 and DupA genotype are highly predictive of gastric injuries in our context.
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