Potentially Infectious Helicobacter pylori in Tap Water in Kermanshah, Western Iran

Background: Although the pathogenesis of Helicobacter pylori is well-defined, the origin and transmission of the bacterium have remained largely unknown. The water transmission hypothesis suggested that water acts as a carrier in oral-fecal transmission, especially in high-prevalence areas. We aimed to evaluate the possible contamination of tap water with infective H. pylori in Kermanshah, Iran from Sep-Oct 2020. Methods: Tap water samples were collected from varieties of probable high-alert regions and the viability of H. pylori were achieved using culture and real-time PCR techniques (ureA gene expression). Results: Out of 50 tap water samples, 3 were positive for H. pylori before enrichment and 6 were positive after enrichment by RT qPCR, while H. pylori colonies of two samples were observed on brucella agar plates. Conclusion: The results of positive samples demonstrated the probable presence of viable H. pylori in tap water samples, showing that tap water distribution systems could be a potential route for H. pylori transmission.