AUTHOR=Liu Dongsheng , Wang Jinyun , Xie Yong 

TITLE=Refractory Helicobacter pylori infection and the gastric microbiota

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2022.976710

DOI=10.3389/fcimb.2022.976710

ISSN=2235-2988

ABSTRACT=Background: Curing refractory H pylori infection was difficult. At present, there was no research about gastric microbiota of refractory H pylori infection. 
Methods: We designed a clinical retrospective study involved with 32 subjects who were divided into three groups: 1. nAGHp. a group: treatment-naïve patients with H. pylori infection; 2. nAGHp.b group: H pylori-negative; 3. EFHp.a group: Patients with Refractory H pylori infection. Gastric mucosa samples that come from the biobank of our research center were collected for 16S rRNA sequencing analysis and bacterial functions were predicted via PICRUSt. 
Results: There were significant differences between H pylori positive group and H pylori negative group in species diversity, gastric microbiota structure and bacterial function. The results of LEfSe analysis suggested that the beneficial Lactobacillates in H pylori positive group was significantly enriched than that in refractory H pylori infection group. The bacterial interaction network diagram suggested that the microbiota interaction in refractory H pylori infection group decreased. Gastric microbiota of the refractory H pylori infection group was enriched in the pathways of metabolism and infection diseases when compared with H pylori-positive group without treatment by PICRUSt analysis. 
Conclusion: In conclusion, significant alterations taken place in gastric microbiota when people failed to eradicate H pylori for many times. Multiple H pylori eradication history would lead to imbalance of gastric mucosal microbiota to a certain extent, which mainly reflected in inhibiting the growth of beneficial lactobacillates in the stomach, patients with refractory H pylori infection may were at a higher risk of developing gastric cancer than other H pylori-positive patients.