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幽门螺杆菌

[Helicobacter pylori].

作者信息

Schulz Christian, Schütte Kerstin

机构信息

Medizinische Klinik und Poliklinik 2, LMU Klinikum München, Marchioninistr. 15, 81377, München, Deutschland.

Standort München, Deutsches Zentrum für Infektionsforschung, München, Deutschland.

出版信息

Inn Med (Heidelb). 2025 Sep 9. doi: 10.1007/s00108-025-01976-4.

Abstract

Helicobacter pylori was first characterized as an obligate bacterial pathogen in 1983. Since then, substantial advances have been made in understanding the pathophysiology of H. pylori infection, optimizing diagnostic and therapeutic strategies, and expanding testing and treatment-including in the prevention of gastric malignancies. The recognition of H. pylori-associated gastritis as an infectious disease led to the recommendation to initiate eradication therapy after any confirmed detection of the pathogen. The marked increase in resistance to commonly used antibiotics has prompted revisions in both national and international clinical guidelines. These include changes to empirical first-line therapy and have fueled ongoing debate regarding the pros and cons of routine pre-treatment antimicrobial susceptibility testing. This CME article provides an overview of the clinical relevance of the topic and also explains indications and methods for guideline-based diagnostics and therapy.

摘要

幽门螺杆菌于1983年首次被鉴定为一种专性细菌病原体。从那时起,在理解幽门螺杆菌感染的病理生理学、优化诊断和治疗策略以及扩大检测和治疗(包括预防胃恶性肿瘤)方面取得了重大进展。将幽门螺杆菌相关性胃炎识别为一种传染病,促使人们建议在确诊病原体后立即开始根除治疗。常用抗生素耐药性的显著增加促使国家和国际临床指南进行修订。这些修订包括经验性一线治疗的改变,并引发了关于常规治疗前抗菌药物敏感性测试利弊的持续争论。这篇继续医学教育文章概述了该主题的临床相关性,并解释了基于指南的诊断和治疗的适应症及方法。

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