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In Group 1, gastric biopsies were used for the isolation of <jats:italic>H. pylori<\/jats:italic> and yeast, rapid urease test (RUT), staining with Gram's and hematoxylin &amp; eosin (H&amp;E), and immunohistochemistry (IHC) methods. In the other three groups, DNAs extracted from <jats:italic>H. pylori<\/jats:italic> and yeasts were used for the amplification of <jats:italic>H. pylori<\/jats:italic>\u2010specific genes. Wet mounts of yeasts in Group 2 were examined to observe intracellular bacteria and released EVs. Among 221 patients, 65 (29.3%) had oral yeast, 35 (15.8%) <jats:italic>H. pylori<\/jats:italic>, and 31 (14%) gastric yeast. Culture of oral yeasts showed a significant correlation with the detection of <jats:italic>H. pylori<\/jats:italic> by IHC (10.3%), Gram stain (9%), RUT (6.3%), H&amp;E (4.9%), and culture (4%) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Gram\u2010stained biopsies showed the occurrence of yeast and <jats:italic>H. pylori<\/jats:italic>, and the release of EVs from yeast. Detection of similar <jats:italic>H. pylori<\/jats:italic> genes in oral and gastric yeasts from patients in Group 2 showed their common source. Oral yeasts in Groups 3 and 4 also carried <jats:italic>H. pylori<\/jats:italic> genes. Wet mount preparations of yeasts showed intracellular bacteria inside the yeast vacuole and the release of EVs that could carry <jats:italic>H. pylori<\/jats:italic>. Oral yeast protects its intracellular <jats:italic>H. pylori<\/jats:italic> and releases it inside EVs to safely reach gastric mucosa. Yeast, as the environmental reservoir of <jats:italic>H. pylori<\/jats:italic>, plays a crucial role in bacterial reinfection after successful eradication.<\/jats:p>","DOI":"10.1002\/yea.3983","type":"journal-article","created":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T06:40:15Z","timestamp":1731739215000},"page":"645-657","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Role of Oral Yeast in Replenishing Gastric Mucosa with Yeast and <i>Helicobacter pylori<\/i>"],"prefix":"10.1002","volume":"41","author":[{"given":"Sara","family":"Kadkhodaei","sequence":"first","affiliation":[{"name":"Department of Microbiology, School of Biology, University College of Sciences University of Tehran Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atousa","family":"Hatefi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Biology, University College of Sciences University of Tehran Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahrzad","family":"Pedramnia","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Biology, University College of Sciences University of Tehran Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elham","family":"Godini","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Biology, University College of Sciences University of Tehran Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saman","family":"Khalili\u2010Samani","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Biology, University College of Sciences University of Tehran Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parastoo","family":"Saniee","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology Shahid Beheshti University G.C Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdolfattah","family":"Sarrafnejad","sequence":"additional","affiliation":[{"name":"Department of Immunology, School of Public Health Tehran University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali\u2010Hatef","family":"Salmanian","sequence":"additional","affiliation":[{"name":"Department of Agricultural Biotechnology National Institute of Genetic Engineering and Biotechnology (NIGEB) Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masoud","family":"Sotoudeh","sequence":"additional","affiliation":[{"name":"Digestive Disease Research Center, Digestive Diseases Research Institute Tehran University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David Y.","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Medicine Michael E. 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