Sl. Hazell et al., HELICOBACTER-PYLORI - METABOLISM, PHYSIOLOGY AND INSIGHTS FROM THE WHOLE GENOME, Bailliere's clinical infectious diseases, 4(3), 1997, pp. 283-317
Helicobacter pylori (synonymous with gastric Campylobacter-like organi
sm (GCLO), Campylobacter pyloridis and Campylobacter pylori) is a bact
erium transmitted from person to person and causally linked to the dev
elopment of peptic ulcer disease and gastric cancer. Yet this pathogen
is usually considered to be outside the realm of the infectious disea
se specialist. The reason for this is historical. Peptic ulcer disease
and gastric cancer have been the province of gastroenterologists and
oncologists for many years. The discovery of H. pylori was an unexpect
ed event that impinged on the very foundations of many of the tenets o
f gastroenterology and induced considerable controversy within this sp
eciality. While a number of microbiologists and infectious disease cli
nicians have made significant contributions to our understanding of th
is important pathogen, many infectious disease specialists have played
only a peripheral role in diagnosis and patient management. The advan
ce of diagnostic tests, the application of multiple drug treatment reg
imens and the rapid realization that antibiotic resistance represents
an important issue in the longterm management of this infection, point
to an increasing need for gastroenterologists to consult professional
microbiologists and infectious disease specialists. For the professio
nal microbiologist and the infectious disease specialist there is a ne
ed to understand this bacterium and how it has adapted to life in the
human stomach. This chapter is intended to give an overview of the bac
terium as an inhabitant of the human stomach. it focuses on the primar
y metabolic and physiological mechanisms of H. pylori. As adaptation t
o the human host represents a necessary prerequisite for the developme
nt of specific disease, aspects of bacterial host interactions are add
ressed.