A case of early intra-familial reinfection with helicobacter pylori infection in a patient with chronic non-atrophic gastritis who had previously undergone successful eradication therapy

Abstract

A case of early intrafamilial reinfection with H. pylori in a patient with chronic non-atrophic gastritis—who had previously undergone successful eradication therapy—was analyzed, and its pathogenesis was explained. It was determined that a close relative—the patient’s father, who also suffered from chronic non-atrophic gastritis—lived in the same apartment and shared the same bathroom facilities with the patient. Over a six-month period, the father frequently (five times) took proton pump inhibitor (PPI) courses, each lasting 6–8 days, to manage exacerbations of his condition. Furthermore, it was noted that during the six months following his own treatment, the patient experienced severe stress related to the military conflict in Ukraine. Breath tests performed immediately after treatment and one month post-treatment were negative for H. pylori infection; however, a test conducted six months post-treatment returned a positive result. The patient’s early H. pylori reinfection was attributed to a fecal-oral transmission route, which occurred through contact between the patient’s palm and the father’s palm—the latter having been contaminated with an inactive form of H. pylori following defecation—as well as contact with surfaces in the bathroom that served as reservoirs for the bacteria. The father was an active shedder (donor) of inactive forms of H. pylori following his use of a PPI, while the patient (recipient) was under stress—a state that reduced both gastric acidity and immune defenses, thereby facilitating the rapid transition of the inactive H. pylori into its active form and allowing it to re-colonize the patient’s gastric mucosa.