CagA-positive may promote and aggravate scrub typhus.

() infection may alter the host's resistance to disease pathogens through the Th1 immune response, leading to potential synergistic pathogenic effects. A total of 117 scrub typhus cases at Beihai People's Hospital and affiliated hospitals of Youjiang University for Nationalities and Medical Sciences were studied from January to December 2022, alongside 130 healthy individuals forming the control group. All participants underwent serum antibody testing. The prevalence of infection was significantly higher among scrub typhus patients (89.7%) compared to healthy individuals (54.6%) ( < 0.05). Moreover, type I infection was notably more prevalent in scrub typhus cases (67.5%) compared to healthy individuals (30%) ( < 0.05). Multifactorial analysis demonstrated type I infection as an independent risk factor for scrub typhus (adjusted odds ratio: 2.407, 95% confidence interval: 1.249-4.64,  = 0.009). Among scrub typhus patients with multiple organ damage, the prevalence of type I infection was significantly higher (50.6%) than type II infection (15.4%) (2 = 4.735,  = 0.030). These results highlight a higher incidence of infection in scrub typhus patients compared to the healthy population. Additionally, type I strain emerged as an independent risk factor for scrub typhus development. Moreover, individuals infected with type I are more susceptible to multiple organ damage. These findings suggest a potential role of carrying the CagA gene in promoting and exacerbating scrub typhus.