Quantitative Microbial Risk Assessment of Helicobacter pylori and Enteric Pathogens in Fresh Vegetables in the Central Highlands of Peru

The rise in global consumption of fresh vegetables is a response to their nutrient-dense composition and low caloric content—key factors for optimising human metabolic health. This study evaluated the Quantitative Microbial Risk Assessment (QMRA) of Helicobacter pylori and enteric pathogens in fresh vegetables within the central highlands of Peru. The research integrated conventional microbiology, qPCR, and Monte Carlo simulations. The results revealed a high prevalence of Escherichia coli (83.7%), with a heterogeneous distribution where Huancayo presented the highest prevalence (95.5%) and Chupaca the lowest (68.2%). In contrast, pathogens such as H. pylori and Campylobacter jejuni showed marginal prevalences of 2.33% and 3.49%, respectively, with detections restricted to leafy and root vegetables at specific points of sale. Although biochemical tests indicated the presumptive presence of Helicobacter pylori, the qPCR results were negative, possibly due to the bacteria’s viable but non-culturable (VBNC) state. The QMRA model showed a highly skewed annual infection risk distribution, with E. coli presenting the highest risk: median Pann = 1.000 and 84.3% of simulations exceeding the WHO tolerable threshold of 10−4. For Salmonella Typhimurium and Shigella flexneri, 22.4% and 9.1% of simulations exceeded the same threshold, respectively. The results underscore the urgent need to implement traceability programs and improve agricultural practices across the evaluated provinces.