This is probably due to sub-clone presence with high rates of plastic recombination with H. pylori genome, emerging from microevolution processes or to co-infection with multiple H. pylori strains that coexist in the same patient [36], also may be due to that H. pylori isolates from gastric biopsies is often made by the sweeping method instead of individual colony selection [24]; hence, presence of multiple cagA genotypes in the same patient was observed. The gene discussed is S100A8; the disease is coinfection.