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Abstract

Recurrence of Helicobacter pylori infection after successful eradication occurs and is associated with relapse of gastroduodenal diseases. The aims of this paper were to assess the incidence and identify the nature and possible causes of recurrence of the infection. A broad-based Medline search was performed to identify all related publications addressing recurrence of the infection between 1986 and 1995. The 12-month recurrence rate varied among the different studies from 0 to 41.5%. A few studies showed 18- to 24-month recurrence rates, which ranged between 0 and 21.4%. Limited data, obtained using molecular fingerprinting techniques, have shown that in most cases recurrence is due to recrudescence of the original strain; a few cases appear to be due to reinfection with a new strain. Recrudescence is most likely during the first 12 months after apparent eradication. Despite the high sensitivity and specificity of the available individual tests for detecting H. pylori infection in untreated patients, no technique alone is sensitive enough to monitor eradication when the four-week-rule definition for eradication is used. A combination of two or more techniques increases sensitivity. Sensitivity and specificity are increased when biopsies are taken from both gastric antrum and corpus. The best treatments have the lowest recurrence rates and recurrence is rare when the eradication rate is over 90%. Individual susceptibility and reexposure to H. pylori are suggested as two major causes of reinfection.

Long-term follow up Helicobacter Pylori reinfection rate after second-line treatment: bismuth-containing quadruple therapy versus moxifloxacin-based triple therapy

“…That is, the eradication rate of per protocol (PP) analysis decreased up to 75.9% in 2006 [9]. Some studies reported that the recurrence of H. pylori infection more frequently occurred in patients treated with a low efficacy regimen than in those treated with a high efficacy regimen, as a result of recrudescence of the organism after temporary suppression, not elimination [14,16,22,23]. In the previous studies, the PP eradication rates were reported at 77.2% for the 7- and 93.6% for the 14 day EBMT regimen [24], and 83.8% for the 7-, 82.6% for the 10- and 79.9% for the 14 day MEA regimen [25].…”

Low rate of recurrence of Helicobacter Pylori infection in spite of high clarithromycin resistance in Pakistan

“…This discrepancy might be explained by the fact that criteria to define eradication of infection, number of patients studied, and time of follow-up varied from one study to another [8,20-22]. Increased susceptibility of hosts to H. pylori infection and re-exposure to H. pylori are proposed to be the major requirements for re-infection of H. pylori [23,24]. Poor sanitation practices in the developing countries result in contamination of the environment with H. pylori , such as in drinking water, practice of eating uncooked vegetables; crowded living conditions thatl contribute to re-exposure to H. pylori infection and result in high prevalence of H. pylori infection [25-27].…”

The Puzzle of Coccoid Forms of Helicobacter pylori: Beyond Basic Science

“…Relapse is mainly due to the same bacterium of the first infection and might occur by the transformation of spiral forms of H. pylori into coccoid ones resistant to antibiotics with a successive reversion as well as by the development of a biofilm inaccessible to antibiotics that is able to surround and protect coccoid bacteria [81][82][83].…”