The significance of Helicobacter pylori in water, food and environmental samples

Infection by Helicobacter pylori is recognized as the major cause of gastric disease and its prevalence is elevated worldwide. It is hypothesised that the transmission of H. pylori involves multiple pathways: iatrogenic, oral-oral and faecal-oral. Food and water are suspects of serving as vehicles in the faecal-oral route of H. pylori infection. However, the difficult cultivation of H. pylori from samples with high loads of accompanying microflora and its conversion to viable but nonculturable state (VNC) impair the elucidation of the real role of waterborne and foodborne infections by this pathogen. In this sense, it is crucial the development of methods for isolation of H. pylori from environmental samples. In this work, an overview of the present knowledge on epidemiology and transmission of H. pylori is presented, attempting to the possible role of water and foods in the spread of the infection. (C) 2003 Elsevier Ltd. All rights reserved.