The recurrence of H. pylori infection

The rate of H. pylori recurrence after eradication of the microorganism seems to be relatively low, at least in developed countries, where the mean annual reinfection rate is of approximately 3% per patient-year of follow-up, although the risk of reinfection in some developing regions is considerably higher. Several findings suggest that recrudescence (復發) rather than reinfection is likely to be responsible for most cases of recurrence: (i) the recurrences decrease with time and decline sharply after the first year, and (ii) studies using molecular fingerprinting techniques (polymerase chain reaction) confirm that the identified microorganisms (before and after therapy) are usually genetically identical. The lower the efficacy (功效) of an antibiotic therapy, the greater the likelihood that recurrence occur, again suggesting that in these cases temporary "clearance" has been achieved rather than true eradication... Some studies suggest that recurrence is relatively infrequent, even if the patient's spouse is H. pylori-positive, suggesting that the patient's partner does not act as a reservoir for the reinfection. However, other investigators achieve contrary (相反) results, although a common exogenous (外源性) source of H. pylori (for both partner's infection and patient's reinfection) cannot be ruled out. The oral cavity may be a potential source for recrudescence of gastric infection after successful therapy…

Gisbert, J.P. (2005) The recurrence of Helicobacter pylori infection: incidence and variables influencing it. A critical review. Am J Gastroenterol. 100(9):2083-99. DOI: 10.1111/j.1572-0241.2005.50043.x

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