Editor,—Following the publication of our paper,1 we would like to thank the above authors for their comments and respond in order to clarify our study methodology, interpretation of the data, the impact of the media, and comment on the directions of future work in this area.

The possibility of PCR contamination has been suggested by Franciosi and Koletzko and we agree that this is a potential problem in studies of this type. We guarded against this by utilisation of separate laboratory areas and pipettes for pre-PCR, PCR and post-PCR stages of the procedure, use of sterile bunged pipette tips, and inoculation of the positive control as a last step in the pre-PCR preparation. In each run, we used sterile distilled water and DNA extract from human ureter as negative controls, and we examined samples in duplicate. Throughout our study, duplicated samples consistently gave concordant results, and negative controls were consistently negative.1

Dr Koletzko suggests that the two separate nested PCR-ELISAs utilised in our study may have doubtful specificity as we did not sequence the products. We agree that amplicon sequencing is desirable not only to ensure specificity but in the present context would also provide additional data on the molecular epidemiology of thecagA gene which was detected in these cases. We believe our assays to be …