Endoscopy is not a risk factor for Helicobacter pylori infection--but medical practice is.
BACKGROUND
Previous studies have suggested an increased risk for Helicobacter pylori infection in physicians who perform UGI endoscopy because of exposure to potentially infectious gastric secretions. Therefore, the H. pylori infection status of the endoscopy staff was compared with the H. pylori prevalence of medical staff without endoscopy experience and control subjects who had no contact with patients.


METHODS
The noninvasive 13C-urea breath test was performed in 2108 volunteers: 1460 physicians (mean age 44 +/- 12 years), 235 nurses (33 +/- 10 years), and 413 control subjects (43 +/- 12 years) who were not working in clinical medicine. All subjects completed a questionnaire concerning the weekly frequency of gastroscopies and the duration of endoscopic experience.


RESULTS
Overall, 37.4% of the physicians and 35.3% of the nurses, but only 27.1% of the control subjects were infected. H. pylori infection was not significantly different between endoscopy-performing (37.8%; n = 1091) and general medical staff (35.9%; n = 604). Neither the frequency of gastroscopies nor the duration of endoscopy practice correlated with H. pylori status. With respect to the age distribution; however, a statistically significant higher prevalence of H. pylori was observed in physicians and nurses compared with the 413 control subjects without patient contact (p < 0.01).


CONCLUSIONS
UGI endoscopy is not a risk factor for H. pylori infection, but medical practice slightly raises H. pylori acquisition.
Braden
B
B
Department of Internal Medicine II, Center of Internal Medicine, University of Frankfurt/Main, Germany.
Duan
L P
LP
Caspary
W F
WF
Lembcke
B
B
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D005773:Gastroscopy / Q000009:adverse effects*; D005858:Germany / Q000453:epidemiology; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009726:Nurses; D009784:Occupational Diseases / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D010820:Physicians; D015995:Prevalence; D011336:Probability; D012307:Risk Factors; D017678:Sex Distribution; D011795:Surveys and Questionnaires