Helicobacter Pylori as a Gramnegative Microaerophilic Bacterium

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In 10% of the total infected population, the infection can lead to stomach adenocarcinoma and in the remaining 90%, the infection can persist life long even under vigorous host immune response leading to life long colonization [1]. Although the organism is now known to have infected humans for a long time, it was first identified and successfully cultured in the early 1980s by Dr Barry J. Marshall and Dr J. Robin Warren [2].Triple therapy and quadruple therapy are the two most widely practised treatment methods used against H. pylori infection [3]. However, evolution has armed these gut pathogens with effective means to parry unfavorable situations. The uniqueness of these bacteria lies in the fact that they can survive the acidic environment of the host gut by neutralizing the acidic pH of the stomach by high urease activity that is present both on the surface and in the cytoplasm [4]. Acidic pH of the stomach may also contribute to the ineffectiveness of antibiotic therapy and therefore is another significant obstacle [5]. The high burden of bacteria in the stomach and their ability to form biofilms aggravates the condition. Reversible resistance of Helicobacter pylori is another challenge in its treatment. It is known that such kind of resistance in bacteria is manifested often when a non-replicating bacterial population is present that can survive until antibiotic therapy is stopped [6, 7]. As H. pylori is capable of maintaining pH lower than 6, maintaining a non-replicating stage and in the process conferring reversible resistance and increasing the local pH might restore replication. This has become the principle behind the success of dual therapy with proton pump inhibitor (PPI) and amoxicillin [8]. The treatment for H.pylori infection is widely recommended.