{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:36:30Z","timestamp":1791308190443,"version":"4.3.1"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T00:00:00Z","timestamp":1691452800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:p>This study used multilocus sequence typing (MLST) to investigate the prevalence of <jats:italic>Helicobacter pylori<\/jats:italic> (<jats:italic>H. pylori<\/jats:italic>) mixed infections and <jats:italic>H. pylori<\/jats:italic> mixed infections involving unrelated strains; and determined the phylogeographic groups of <jats:italic>H. pylori<\/jats:italic> recovered from patients in Ningbo, China. A total of 156 <jats:italic>H. pylori<\/jats:italic> isolates were obtained from a convenience sample of 33 patients with culture-positive <jats:italic>H. pylori<\/jats:italic> infection. MLST was used to classify 150 <jats:italic>H. pylori<\/jats:italic> clinical isolates and 12 methodological control strains (6 clinical isolates and 6 strains of American Type Culture Collection <jats:italic>H. pylori<\/jats:italic>) into 43 and 12 sequence types (STs), respectively. In this study, 246 new alleles and 53 new STs were identified by MLST. The prevalence of mixed infections was 41% (11\/27). The prevalence of <jats:italic>H. pylori<\/jats:italic> mixed infections involving unrelated strains was 46% (5\/11) and the prevalence of <jats:italic>H. pylori<\/jats:italic> mixed infections involving completely unrelated strains (strains with all 7 housekeeping genes different) was 36% (4\/11). A phylogenetic tree was created to determine the evolutionary relationships between different strains. The STs in this study were clustered within the hspEAsia subgroup (98%) and hpEurope group (2%). <jats:italic>H. pylori<\/jats:italic> mixed infections were common in Ningbo, China. The <jats:italic>H. pylori<\/jats:italic> isolates belonging to the hpEurope group were recovered from three different biopsy samples in a native Chinese patient. Most of <jats:italic>H. pylori<\/jats:italic> strains colonizing the antrum, corpus, and duodenum bulb were homologous.<\/jats:p>","DOI":"10.3389\/fmicb.2023.1207878","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T07:25:47Z","timestamp":1691479547000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["High prevalence of Helicobacter pylori mixed infections identified by multilocus sequence typing in Ningbo, China"],"prefix":"10.3389","volume":"14","author":[{"given":"Yongxiong","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiying","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhouhong","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiqin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Airu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huikun","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingming","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,8,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1046\/j.1365-2958.1999.01382.x","article-title":"Recombination and clonal groupings within Helicobacter pylori from different geographical regions.","volume":"32","author":"Achtman","year":"1999","journal-title":"Mol Microbiol."},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4178-x","article-title":"Genotypic determination of resistance and heteroresistance to clarithromycin in Helicobacter pylori isolates from antrum and corpus of Colombian symptomatic patients.","volume":"19","author":"Ar\u00e9valo-Jaimes","year":"2019","journal-title":"BMC Infect. 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