Sharara Ala I, Alsohaibani Fahad I, Alsaegh Ahmad, Al Ejji Khalid, Al Awadhi Sameer, Malfertheiner Peter, Karam Sherif A, Al-Taweel Talal
Department of Internal Medicine, American University of Beirut Medical Center, Beirut 961, Lebanon.
Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh 11239, Saudi Arabia.
World J Gastroenterol. 2025 Jul 21;31(27):107138. doi: 10.3748/wjg.v31.i27.107138.
(), a widespread gram-negative bacterium that colonizes the stomach, causes chronic gastritis, which may progress to peptic ulcer, mucosa-associated lymphoid tissue lymphoma, and gastric cancer. infection affects over 50% of people in developing countries and 10%-20% in developed countries. The Kyoto consensus classifies gastritis as an infectious disease in the International Classification of Disease 11 Revision. The Maastricht/Florence consensus recommends treatment for all infected individuals, introducing a shift in the management strategies. The prevalence of infection is high in the Middle East, with infection rates of 40%-70% and 85%-90% being reported among children and adults, respectively. The increasing resistance to antibiotics, including macrolides and fluoroquinolones, is a major challenge in the management of . Clarithromycin resistance, which is associated with reduced effectiveness of standard triple therapy regimens, leading to higher rates of treatment failure, impacts the eradication rates. This emphasizes the need for routine antibiotic susceptibility testing at the national level, the use of alternative therapies, including new molecular methods, and antibiotic stewardship. An online panel of experts from the Middle East, along with an international expert, developed this consensus to provide comprehensive guidelines on the diagnosis, treatment, prevention, and role of gut microbiota in infection, with the goal of improving clinical decision-making and reducing the impact of antibiotic resistance in the region. These guidelines are intended to support healthcare professionals involved in the diagnosis and management of , including primary care physicians, gastroenterologists, and other specialists. They may also inform future clinical research aimed at optimizing treatment strategies and addressing regional challenges.
幽门螺杆菌是一种广泛存在的革兰氏阴性菌，可定植于胃部，引发慢性胃炎，进而可能发展为消化性溃疡、黏膜相关淋巴组织淋巴瘤和胃癌。幽门螺杆菌感染在发展中国家影响超过50%的人口，在发达国家影响10%-20%的人口。《京都共识》在《国际疾病分类第11次修订版》中将幽门螺杆菌胃炎归类为传染病。《马斯特里赫特/佛罗伦萨共识》建议对所有感染者进行治疗，这导致了管理策略的转变。中东地区幽门螺杆菌感染率很高，据报道儿童和成人的感染率分别为40%-70%和85%-90%。包括大环内酯类和氟喹诺酮类在内的抗生素耐药性不断增加，是幽门螺杆菌管理中的一项重大挑战。克拉霉素耐药性与标准三联疗法方案有效性降低相关，导致治疗失败率升高，影响根除率。这凸显了在国家层面进行常规抗生素敏感性检测的必要性，使用包括新分子方法在内的替代疗法，以及抗生素管理。来自中东的一个在线专家小组与一位国际专家共同制定了本共识，以提供关于幽门螺杆菌感染的诊断、治疗、预防以及肠道微生物群作用的全面指南，目标是改善临床决策并减少该地区抗生素耐药性的影响。这些指南旨在支持参与幽门螺杆菌诊断和管理的医疗专业人员，包括初级保健医生、胃肠病学家和其他专科医生。它们还可能为旨在优化治疗策略和应对地区挑战的未来临床研究提供参考。
