Division of Gastroenterology, Brown University, 593 Eddy Street, POB 240, Providence, RI 02903, USA.
Department of Gastroenterology, Hepatology and Nutrition, University of Toronto, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada; Cell Biology Program, The Hospital for Sick Children, 686 Bay Street, Toronto, Ontario M5G0A4, Canada.
Gastroenterol Clin North Am. 2021 Jun;50(2):261-282. doi: 10.1016/j.gtc.2021.02.001.
Helicobacter pylori infection remains one of the most prevalent infections worldwide, causing significant morbidity and mortality from gastric malignancies and peptic ulcers. This article provides a summary of the microbiology and pathogenesis of this bacterium, emphasizing the complex and protean effects of H pylori on gastric epithelial cells, including stem and progenitor populations, and evasion of host immune defenses. Increasing antibiotic resistance has made management more challenging. This article discusses the appropriate diagnostic modality for different clinical scenarios, and the evolving treatment of H pylori infections, including the use of antibiotic susceptibility testing to aid regimen selection.
幽门螺杆菌感染仍然是全球最普遍的感染之一,导致胃恶性肿瘤和消化性溃疡的发病率和死亡率显著升高。本文总结了该细菌的微生物学和发病机制,强调了 H pylori 对胃上皮细胞(包括干细胞和祖细胞)的复杂和多变的影响,以及逃避宿主免疫防御的机制。抗生素耐药性的增加使得管理更加具有挑战性。本文讨论了不同临床情况下的适当诊断方式,以及 H pylori 感染的治疗方法的演变,包括使用抗生素敏感性测试来辅助方案选择。