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Ethics code: Host-pathogen interactions and susceptibility factors

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Helicobacter pylori Infection: A Narrative Review of Epidemiology, Growth Characteristics, Transmission, and Current Diagnostic Approaches
Haleema Sadia , Muhammad Adil * , Mirwaise Khan , Anum Urooj , Talha Najam
Department of Clinical Medicine and Surgery, University of Agriculture Faisalabad, Pakistan
Abstract:   (13 Views)
Introduction: Helicobacter pylori (H. pylori) infection is one of the most common chronic bacterial infections of the gastric mucosa. Its prevalence is estimated in approximately half of the world’s population and varies between 30% and 90% depending on geographic and socioeconomic factors. It is strongly associated with chronic gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric malignancy. This narrative review aims to provide an updated overview of H. pylori infection, including its epidemiology, growth characteristics, transmission routes, risk factors, diagnostic approaches, and current treatment strategies. Methods: This narrative review synthesizes evidence retrieved from PubMed, Scopus, and Web of Science databases for articles published between 2000 and 2025. Results: Global prevalence of H. pylori infection varies considerably across regions, ranging from approximately 30% to 90%, with higher rates reported in developing countries. Transmission occurs predominantly via oral–oral, fecal–oral, and intrafamilial routes. Major risk factors include childhood exposure, overcrowded living conditions, poor sanitation, and low socioeconomic status. Current diagnostic techniques are broadly classified into invasive and non-invasive methods. Invasive techniques include culture, molecular assays, histology, and the rapid urease test (RUT), whereas non-invasive methods include the urea breath test (UBT), stool antigen testing (SAT), and serology. The UBT and SAT are currently among the most accurate non-invasive tools for detecting active infection. Current guidelines recommend proton pump inhibitor (PPI) or potassium-competitive acid blocker (PCAB)-based regimens combined with antibiotics, with bismuth-containing quadruple therapy preferred in regions with high or unknown clarithromycin resistance. Rising antimicrobial resistance, particularly to clarithromycin, metronidazole, and fluoroquinolones, continues to compromise eradication success and highlights the need for susceptibility-guided therapy where available. Conclusion: Despite advances in the understanding and management of H. pylori infection, its high global prevalence and the growing emergence of antimicrobial resistance remain major challenges. Continued efforts are needed to develop region-specific treatment strategies, effective preventive measures, and novel vaccines and therapeutic approaches.

 
Keywords: Helicobacter pylori, Helicobacter infections, Epidemiology, Antimicrobial resistance, Quadruple therapy
     
Type of Study: Review article | Subject: Host-pathogen interactions and susceptibility factors
Received: 2026/02/20 | Accepted: 2026/09/10
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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.