Antibiotic resistance in Helicobacter pylori: a genetic and physiological perspective

Rania G. Elbaiomy; Xiaoling Luo; Rong Guo; Shiyuan Deng; Meifang Du; Ahmed H. El-Sappah; Mohammed Bakeer; Mahmoud M. Azzam; Ahmed A. Elolimy; Mahmoud Madkour; Zaixin Li; Zhi Zhang

doi:10.1186/s13099-025-00704-5

Antibiotic resistance in Helicobacter pylori: a genetic and physiological perspective

Rania G. Elbaiomy, Xiaoling Luo, Rong Guo, Shiyuan Deng, Meifang Du, Ahmed H. El-Sappah, Mohammed Bakeer, Mahmoud M. Azzam, Ahmed A. Elolimy, Mahmoud Madkour, Zaixin Li, Zhi Zhang

Department of Integrative Agriculture

Research output: Contribution to journal › Review article › peer-review

Abstract

The identification of Helicobacter pylori (H. pylori) infection as the primary etiology of gastroduodenal diseases represents a significant advancement in the field of gastroenterology. The management of these diseases has undergone a substantial transformation, and antibiotic treatment is now universally applicable. H. pylori has been the subject of numerous investigations to determine the prevalence of antibiotic resistance. However, many of these studies are limited, particularly regarding the number and representativeness of the strains assessed. Genetic and physiological modifications, such as gene mutations, efflux pump alterations, biofilm formation, and coccoid formation, contribute to the observed resistance. Our review focuses on the emergence of antibiotic-resistant strains, particularly emphasizing the various modifications of H. pylori that confer this resistance. In conclusion, we elucidate the challenges, potential solutions, and prospects in this field, providing researchers with the knowledge necessary to overcome the resistance exhibited by H. pylori.

Original language	English
Article number	35
Journal	Gut Pathogens
Volume	17
Issue number	1
DOIs	https://doi.org/10.1186/s13099-025-00704-5
Publication status	Published - Dec 2025

Keywords

Biofilm
Clarithromycin
Efflux pump systems
H. pylori
Penicillin
Resistance

ASJC Scopus subject areas

Parasitology
Microbiology
Gastroenterology
Virology
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s13099-025-00704-5

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title = "Antibiotic resistance in Helicobacter pylori: a genetic and physiological perspective",

abstract = "The identification of Helicobacter pylori (H. pylori) infection as the primary etiology of gastroduodenal diseases represents a significant advancement in the field of gastroenterology. The management of these diseases has undergone a substantial transformation, and antibiotic treatment is now universally applicable. H. pylori has been the subject of numerous investigations to determine the prevalence of antibiotic resistance. However, many of these studies are limited, particularly regarding the number and representativeness of the strains assessed. Genetic and physiological modifications, such as gene mutations, efflux pump alterations, biofilm formation, and coccoid formation, contribute to the observed resistance. Our review focuses on the emergence of antibiotic-resistant strains, particularly emphasizing the various modifications of H. pylori that confer this resistance. In conclusion, we elucidate the challenges, potential solutions, and prospects in this field, providing researchers with the knowledge necessary to overcome the resistance exhibited by H. pylori.",

keywords = "Biofilm, Clarithromycin, Efflux pump systems, H. pylori, Penicillin, Resistance",

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year = "2025",

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doi = "10.1186/s13099-025-00704-5",

language = "English",

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journal = "Gut Pathogens",

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T1 - Antibiotic resistance in Helicobacter pylori

T2 - a genetic and physiological perspective

AU - Elbaiomy, Rania G.

AU - Luo, Xiaoling

AU - Guo, Rong

AU - Deng, Shiyuan

AU - Du, Meifang

AU - El-Sappah, Ahmed H.

AU - Bakeer, Mohammed

AU - Azzam, Mahmoud M.

AU - Elolimy, Ahmed A.

AU - Madkour, Mahmoud

AU - Li, Zaixin

AU - Zhang, Zhi

N1 - Publisher Copyright: © The Author(s) 2025.

PY - 2025/12

Y1 - 2025/12

N2 - The identification of Helicobacter pylori (H. pylori) infection as the primary etiology of gastroduodenal diseases represents a significant advancement in the field of gastroenterology. The management of these diseases has undergone a substantial transformation, and antibiotic treatment is now universally applicable. H. pylori has been the subject of numerous investigations to determine the prevalence of antibiotic resistance. However, many of these studies are limited, particularly regarding the number and representativeness of the strains assessed. Genetic and physiological modifications, such as gene mutations, efflux pump alterations, biofilm formation, and coccoid formation, contribute to the observed resistance. Our review focuses on the emergence of antibiotic-resistant strains, particularly emphasizing the various modifications of H. pylori that confer this resistance. In conclusion, we elucidate the challenges, potential solutions, and prospects in this field, providing researchers with the knowledge necessary to overcome the resistance exhibited by H. pylori.

AB - The identification of Helicobacter pylori (H. pylori) infection as the primary etiology of gastroduodenal diseases represents a significant advancement in the field of gastroenterology. The management of these diseases has undergone a substantial transformation, and antibiotic treatment is now universally applicable. H. pylori has been the subject of numerous investigations to determine the prevalence of antibiotic resistance. However, many of these studies are limited, particularly regarding the number and representativeness of the strains assessed. Genetic and physiological modifications, such as gene mutations, efflux pump alterations, biofilm formation, and coccoid formation, contribute to the observed resistance. Our review focuses on the emergence of antibiotic-resistant strains, particularly emphasizing the various modifications of H. pylori that confer this resistance. In conclusion, we elucidate the challenges, potential solutions, and prospects in this field, providing researchers with the knowledge necessary to overcome the resistance exhibited by H. pylori.

KW - Biofilm

KW - Clarithromycin

KW - Efflux pump systems

KW - H. pylori

KW - Penicillin

KW - Resistance

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DO - 10.1186/s13099-025-00704-5

M3 - Review article

AN - SCOPUS:105005800566

SN - 1757-4749

VL - 17

JO - Gut Pathogens

JF - Gut Pathogens

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ER -

Antibiotic resistance in Helicobacter pylori: a genetic and physiological perspective

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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