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Three-Decade Failure to the Eradication of Refractory Helicobacter pylori Infection and Recent Efforts to Eradicate the Infection

[ Vol. 22 , Issue. 7 ]


Majid Taati Moghadam, Zahra Chegini, Amin Norouzi, Amin Sadeghi Dousari and Aref Shariati*   Pages 937 - 951 ( 15 )


Background: Helicobacter pylori causes dangerous and deadly diseases such as gastric cancer and duodenal ulcers. Eradication and treatment of this bacterium are very important due to the deadly diseases caused by H. pylori and the high cost of treatment for countries. Thus, we present a complete list of the most important causes of failure in the treatment and eradication of H. pylori, and address new therapeutic methods that may be effective in controlling this bacterium in the future.

Results: Many efforts have been made to control and eradicate this bacterium over the years, but no success has been achieved since its eradication is a complex process affected by the bacterial properties and host factors. Previous studies have shown that various factors are involved in the failure to eradicate H. pylori, such as new genotypes of the bacterium with higher pathogenicity, inappropriate patient cooperation, mutations, biofilm formation and dormant forms that cause antibiotic resistance, acidic stomach pH, high bacterial load, smoking, immunosuppressive features and intracellular occurrence of H. pylori. On the other hand, recent studies reported that the use of probiotics, nanoparticles, antimicrobial peptides, natural product and vaccines can be helpful in the treatment and eradication of H. pylori infections.

Conclusion: Eradication of H. pylori is crucial for the treatment of important diseases such as gastric cancer. Therefore, it seems that identifying the failure causes of treating this bacterium can be helpful in controlling the infections. Besides, further studies on new therapeutic strategies may help eradicate H. pylori in the future.


Helicobacter pylori, eradication failure, gastric cancer, peptic ulcers, new therapeutic strategies, refractory Helicobacter pylori infection.


Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Student Research Committee, Iran University of Medical Sciences, Tehran, Department of Microbiology and Virology, School of Medicine, Kerman University of Medical Sciences, Kerman, Jiroft University of Medical Sciences, Jiroft, Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran

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