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

Reza Ranjbar,Nematollah Jonaidi-Jafari,Faham Khamesipour,Ebrahim Rahimi

doi:10.1186/s12866-016-0647-1

Abstract

BackgroundUp 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.ResultsOf 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.ConclusionsContaminated 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.

Highlights

Up to now, fecal–oral and oral–oral are the most commonly known routes for transmission of H. pylori, contaminated water can play an important role in transmission of H. pylori to humans
A total of 450 bottled mineral water samples were examined for the presence of H. pylori, its genotypes, and its antimicrobial resistance properties
We found that the bottled mineral water samples from July had the highest levels of H. pylori-contamination (50 %)

Summary

Introduction

Fecal–oral and oral–oral are the most commonly known routes for transmission of H. pylori, contaminated water can play an important role in transmission of H. pylori to humans. Bottled mineral waters are a rich sources of trace elements copper, zinc, and iron and magnesium, fluorine, sodium, and calcium. Their consumption is routine in hotels, restaurants, airplanes and other vehicles and medical practitioners usually prescribe these kinds of waters for patients with malnutrition. Based on the fecal–oral and oral–oral transmission routes of the H. pylori, contaminated water can play an important role in spread of H. pylori to humans [8, 9]

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