Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu City, Oita, Japan.
Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, Texas, USA.
Clin Microbiol Rev. 2022 Sep 21;35(3):e0025821. doi: 10.1128/cmr.00258-21. Epub 2022 Apr 11.
Despite the recent decrease in overall prevalence of Helicobacter pylori infection, morbidity and mortality rates associated with gastric cancer remain high. The antimicrobial resistance developments and treatment failure are fueling the global burden of H. pylori-associated gastric complications. Accurate diagnosis remains the opening move for treatment and eradication of infections caused by microorganisms. Although several reports have been published on diagnostic approaches for H. pylori infection, most lack the data regarding diagnosis from a clinical perspective. Therefore, we provide an intensive, comprehensive, and updated description of the currently available diagnostic methods that can help clinicians, infection diagnosis professionals, and H. pylori researchers working on infection epidemiology to broaden their understanding and to select appropriate diagnostic methods. We also emphasize appropriate diagnostic approaches based on clinical settings (either clinical diagnosis or mass screening), patient factors (either age or other predisposing factors), and clinical factors (either upper gastrointestinal bleeding or partial gastrectomy) and appropriate methods to be considered for evaluating eradication efficacy. Furthermore, to cope with the increasing trend of antimicrobial resistance, a better understanding of its emergence and current diagnostic approaches for resistance detection remain inevitable.
尽管幽门螺杆菌感染的总体流行率最近有所下降，但与胃癌相关的发病率和死亡率仍然很高。抗生素耐药性的发展和治疗失败正在加剧与幽门螺杆菌相关的胃部并发症的全球负担。准确的诊断仍然是治疗和根除微生物感染的第一步。尽管已经有几篇关于幽门螺杆菌感染诊断方法的报告发表，但大多数都缺乏从临床角度诊断的数据。因此，我们提供了目前可用的诊断方法的详细、全面和最新描述，这些方法可以帮助临床医生、感染诊断专业人员和从事感染流行病学研究的幽门螺杆菌研究人员扩大他们的理解并选择适当的诊断方法。我们还根据临床环境（临床诊断或大规模筛查）、患者因素（年龄或其他易患因素）和临床因素（上消化道出血或部分胃切除术）强调适当的诊断方法，并考虑评估根除效果的适当方法。此外，为了应对抗生素耐药性不断上升的趋势，更好地了解其出现和当前的耐药性检测诊断方法仍然是不可避免的。
