SUMMARY Despite decades of effort, Helicobacter pylori infections remain difficult to treat. Over half of the world's population is infected by H. pylori, which is a major cause of duodenal and gastric ulcers as well as gastric cancer. During chronic infection, H. pylori localizes within the gastric mucosal layer, including deep within invaginations called glands; thanks to its impressive ability to survive despite the harsh acidic environment, it can persist for the host's lifetime. This ability to survive and persist in the stomach is associated with urease production, chemotactic motility, and the ability to adapt to the fluctuating environment. Additionally, biofilm formation has recently been suggested to play a role in colonization. Biofilms are surface-associated communities of bacteria that are embedded in a hydrated matrix of extracellular polymeric substances. Biofilms pose a substantial health risk and are key contributors to many chronic and recurrent infections. This link between biofilm-associated bacteria and chronic infections likely results from an increased tolerance to conventional antibiotic treatments as well as immune system action. The role of this biofilm mode in antimicrobial treatment failure and H. pylori survival has yet to be determined. Furthermore, relatively little is known about the H. pylori biofilm structure or the genes associated with this mode of growth. In this review, therefore, we aim to highlight recent findings concerning H. pylori biofilms and the molecular mechanism of their formation. Additionally, we discuss the potential roles of biofilms in the failure of antibiotic treatment and in infection recurrence.

发明内容尽管经过数十年的努力，幽门螺杆菌感染仍然难以治疗。世界一半以上的人口感染了幽门螺杆菌，这是十二指肠和胃溃疡以及胃癌的主要原因。在慢性感染期间，幽门螺杆菌定位在胃粘膜层内，包括在称为腺体的内陷深处；由于在恶劣的酸性环境下仍具有出色的生存能力，因此它可以在宿主的生命中持续存在。这种在胃中生存和持久的能力与脲酶的产生，趋化性运动以及适应不断变化的环境的能力有关。另外，最近已提出生物膜形成在定植中起作用。生物膜是嵌入到细胞外聚合物水合基质中的与细菌表面相关的群落。生物膜对健康构成重大威胁，并且是许多慢性和复发性感染的关键因素。生物膜相关细菌与慢性感染之间的这种联系可能是由于对常规抗生素治疗的耐受性增强以及免疫系统的作用所致。这种生物膜模式在抗菌治疗失败和幽门螺杆菌的生存期尚未确定。此外，关于幽门螺杆菌生物膜结构或与该生长模式相关的基因的了解相对较少。因此，在这篇综述中，我们旨在强调有关幽门螺杆菌生物膜及其形成的分子机制的最新发现。此外，我们讨论了生物膜在抗生素治疗失败和感染复发中的潜在作用。