| Summary: | <i>Helicobacter pylori</i> eradication is characterized by decreasing successful eradication rates. Although treatment failure is primarily associated with resistance to antibiotics, other unknown factors may influence the eradication outcome. This study aimed to assess the presence of the antibiotics resistance genes in <i>H. pylori</i> and the presence of <i>Candida</i> spp., which are proposed to be endosymbiotic hosts of <i>H. pylori</i>, in gastric biopsies of <i>H. pylori-</i>positive patients while simultaneously assessing their relationship. The detection and identification of <i>Candida</i> yeasts and the detection of mutations specific for clarithromycin and fluoroquinolones were performed by using the real-time PCR (RT-PCR) method on DNA extracted from 110 gastric biopsy samples of <i>H. pylori</i>-positive participants. Resistance rate to clarithromycin and fluoroquinolone was 52% and 47%, respectively. Antibiotic resistance was associated with more eradication attempts (<i>p</i> < 0.05). <i>Candida</i> species were detected in nine (8.18%) patients. <i>Candida</i> presence was associated with older age (<i>p</i> < 0.05). A high rate of antibiotic resistance was observed, while <i>Candida</i> presence was scarce, suggesting that endosymbiosis between <i>H. pylori</i> and <i>Candida</i> may not be a major contributing factor to the eradication failure. However, the older age favored <i>Candida</i> gastric mucosa colonization, which could contribute to gastric pathologies and microbiome dysbiosis.
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