Objective To investigate Helicobacter pylori(Hp)infection status,strain typing,and their correlations with gastric mucosal lesions in chronic gastritis.Methods A retrospective analysis was conducted on the medical records of 11 500 patients with chronic gastritis who received treatment at Xi'an International Medical Center Hospital,People's Hospital of Wuhai,and People's Hospital of Tongchuan from January to July 2022.Hp test results,strain typing,and the basic characteristics and gastric mucosal lesions of Hp-infected patients were determined.Pearson correlation analysis was performed to assess the correlation between strain types and gastric mucosal lesions.Logistic regression analysis was performed to identify factors influencing Hp infection in patients with chronic gastritis.Results A total of 7 549 cases of Hp infection were identified(65.65%).Patients with more than three family members,farmers and workers,those who frequently drank raw water,consumed pickled foods,did not drink tea,were aged 50 years or older,or had a disease duration of 2 years or more had a higher Hp-positive rate compared with those with fewer than three family members,government officials,those who infrequently drank raw water,did not consume pickled foods,drank tea,were younger than 50 years,or had a disease duration of less than 2 years(all P<0.05).The majority of infected patients harbored the highly virulent type Ⅰ Hp strains(55.65%).The numbers of cases of non-epithelial neoplasia,low-grade intraepithelial neoplasia,high-grade intraepithelial neoplasia,and gastric infiltrating carcinoma were significantly different among different strain types(x2=40.33,7.65,11.39,54.89,all P<0.05).Pearson correlation analysis revealed a significant correlation between non-epithelial neoplasia and strain type(r=0.539,P<0.001).Logistic regression analysis indicated that age ≥ 50 years and disease duration ≥ 2 years were independent factors influencing Hp infection in patients with chronic gastritis(P=0.005,0.002).Conclusion A higher number of family members,being a farmer or a worker,frequently drinking raw water,and consuming pickled foods are associated with an increased rate of Hp infection,while drinking tea is linked to a reduced infection rate.Patients with chronic gastritis are often infected with highly virulent type Ⅰ Hp strain.There is a positive correlation between non-epithelial neoplasia and strain type.Age ≥ 50 years and disease duration ≥2 years are independent factors influencing Hp infection in chronic gastritis.