Objective: The present study aims to determine the possibility of H. pylori coccoid forms to survive in our surrounding environments, thus exhibiting public health hazard. Method: Helicobacter pylori strain Makkah 7 accession number HQ622108, was inoculated in samples of soil, well, tap, swimming pool, and sewage water; in which, an average initial inoculum of 107 CFU/ml was inoculated. The experiment was conducted, outdoor where ambient temperature varied between 39-55°C in Jeddah city, Saudi Arabia. The survival rate of H. pylori strain was quantitatively and qualitatively studied for five months. Results: Viable counts were undetectable after 24 hours, while total count varied between 107 to 106, and declined to 103 bacterial cell/ml five months later. Interestingly, microscopic examination revealed few non-motile rods and motile coccoid forms. All samples were removed and placed at 4°C for one month. Following, total count, morphology, and motility were examined, showing motile coccoid forms. Electron microscopic and, molecular studies were carried out, confirming that the species is H. pylori, which was detected by using 16S rRNA primer for H. pylori with a product size of 163 bp. The ability of H. pylori strain to persist and survive, by being motile in the coccoid form, for five months under such hostile environment, strongly indicates that the coccoid form plays a vital role in the transmission, recrudescence, and therapeutic failure. It is indeed a hazardous and a crucial infectious phase of this bacterium. Conclusion: Detecting coccoid forms in water and soil, accompanied by their eradication, must be seriously considered and applied. Consequently, hindering and preventing different diseases caused by H. pylori.
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