ABSTRACT
Introduction .................................................................................................................................... 579 Genus Description .......................................................................................................................... 580 Epidemiology and Transmission of Helicobacter pylori and Other Helicobacters ....................... 581 Pathogenesis ................................................................................................................................... 584 Virulence Factors ........................................................................................................................... 585
Flagella and Motility .......................................................................................................... 585 Urease ................................................................................................................................. 586 Adhesins ............................................................................................................................. 587 Other Enzymes ................................................................................................................... 587 Lipopolysaccharide ............................................................................................................. 587 Vacuolating Cytotoxin A .................................................................................................... 588 Cytolethal Distending Toxin ............................................................................................... 588 Cytotoxin-Associated Gene Antigen .................................................................................. 588 Coccoid Forms .................................................................................................................... 589
Culture of Helicobacter ................................................................................................................. 589 Specimens for Culture of Helicobacter .............................................................................. 589 Culture Techniques ............................................................................................................. 590
Identication .................................................................................................................................. 590 Antibiotic Susceptibility and Eradication Therapy ........................................................................ 590 Detection Methods ......................................................................................................................... 592 Animal Models for the Study of Helicobacter .............................................................................. 592 References ...................................................................................................................................... 594
Many observations of spiral bacteria colonizing the gastric mucosa of animals and humans have been noted throughout the 20th century, some of which suggested their role in gastric pathology.1-3 Despite the presence of these microorganisms, the stomach was still considered a sterile environment. It was the discovery of Helicobacter pylori that forever changed our perception of the stomach, and made us view this organ as a habitat for specialized bacteria. Current knowledge suggests that H. pylori has most probably colonized the human stomach for thousands of years.4
