Helicobacter pylori in bottled mineral water: genotyping and antimicrobial resistance properties

Background: Up to now, fecal-oral and oral-oral are the most commonly known routes for transmission of H. pylori, therefore, contaminated water can play an important role in transmission of H. pylori to humans. Genotyping using virulence markers of H. pylori is one of the best approaches to study the correlations between H. pylori isolates from different samples. The present research was carried out to study the vacA, cagA, cagE, oipA, iceA and babA2 genotyping and antimicrobial resistance properties of H. pylori isolated from the bottled mineral water samples of Iran. Results: Of 450 samples studied, 8 samples (1.77 %) were contaminated with H. pylori. Brand C of bottled mineral water had the highest prevalence of H. pylori (3.63 %). The bottled mineral water samples of July month had the highest levels of H. pylori-contamination (50 %). H. pylori strains had the highest levels of resistance against metronidazole (62.5 %), erythromycin (62.5 %), clarithromycin (62.5 %), amoxicillin (62.5 %) and trimethoprim (62.5 %). Totally, 12.5 % of strains were resistant to more than 6 antibiotics. VvacAs1a (100 %), vacAm1a (87.5 %), cagA (62.5 %), iceA1 (62.5 %), oipA (25 %), babA2 (25 %) and cagE (37.5 %) were the most commonly detected genotypes. M1as1a (62.5 %), m1as2 (37.5 %), m2s2 (37.5 %) and S1a/cagA+/IceA2/oipA-/babA2-/cagE-(50 %) were the most commonly detected combined genotypes. Conclusions: Contaminated bottled mineral water maybe the sources of virulent and resistant strains H. pylori. Careful monitoring of bottled mineral water production may reduce the risk of H. pylori transmission into the human population.