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Background . The  cag  pathogenicity island ( cag -PAI) is one of the most important virulent determinants of  Helicobacter pylori . An insertion sequence (IS) element of  cag -PAI (IS605) has been found to generate  H. pylori  strains with varying virulence.  Aim . To evaluate the impact of IS605 and  cag -PAI on  H. pylori  strains isolated from Taiwanese patients with severity of gastric diseases.  Methods .  H. pylori  isolates were cultured from gastric biopsies from 99 patients with peptic ulcer, chronic gastritis, and gastric carcinoma. Six distinct, well-separated colonies were isolated from each patient and analyzed by genotyping.  Results .  cagA ,  cagE ,  cagM ,  cagT ,  orf 10, and  orf 13 were found to be present in 90.0%–100.0% of the  H. pylori  isolates. A total deletion of  cagA ,  cagE ,  cagM ,  cagT ,  orf 10, and  orf 13 was found in 1 isolate (1.0%). The IS605 element was found to be positive in 15.2% of the isolates. The presence of IS605 was higher in  H. pylori  isolated from patients with gastric carcinoma (25.0%) than in patients with duodenal ulcer (6.5%) or chronic gastritis (6.3%) ( P  < 0.001).  Conclusions . The majority of the patients examined had intact  cag -PAI. IS605 was present in 15.2% and was higher in  H. pylori  isolated from patients with gastric carcinoma than in those with peptic ulcer.

Association of IS605 andcag-PAI ofHelicobacter pyloriIsolated from Patients with Gastrointestinal Diseases in Taiwan