Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 7 2023 07 15 1514 1521 Banafsheh Hasanvand Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran Somayeh Bakhtiari Reference Laboratory of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran Mahsa Kashef Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran Ramin Abiri Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran Amirhooshang Alvandi Medical Technology Research Center, Research Institute for Health Technology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran 2021 07 20 2022 01 16 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. https://ijph.tums.ac.ir/index.php/ijph/article/view/25629 https://ijph.tums.ac.ir/index.php/ijph/article/download/25629/7994