title: Gut decontamination of critically ill patients reduces Helicobacter pylori acquisition by intensive care nurses.
abstract: The prevalence of Helicobacter pylori is increased in healthcare workers and in intensive care nurses. Exposure to H. pylori from gastric secretions and faeces are probably the main sources of transmission to healthcare workers. Routine use of selective decontamination of digestive tract (SDD) in an intensive care unit suppresses H. pylori in critically ill patients. It was questioned whether this suppression and the subsequent decreased exposure to H. pylori for intensive care nurses would lead to a lower prevalence of H. pylori infection. Helicobacter pylori infection prevalence in intensive care nurses from a unit routinely using SDD (group I) was compared to that of nurses from a unit not using SDD (group II). Heathcare workers from other departments of the hospital where no SDD was used (group III) served as a control group. Persons using proton pump inhibitors were excluded. Helicobacter pylori was detected by Laser Assisted Ratio Analyser(13)C-urea breath test (UBT) and serology. This could not be performed in three out of 64 in group I, five out of 55 in group II and five out of 55 in group III (total UBTs = 169). The prevalence of H. pylori infection was 11% (7/61) in group I and 25.5% (14/50) in group II (P= 0.027). In group III, the prevalence of H. pylori infection was 16% (8/45), which was not significantly different from both group I and II. Sero-prevalence in group I was 18.6%, 27% in group II (ns) and 24% in group III. Mean age in the three groups was 35.9, 37.8 and 36.6 years, respectively (ns). In conclusion, the prevalence of H. pylori infection among intensive care nurses is lower in nurses from a unit using SDD compared to a non SDD-using unit. Acquisition of H. pylori by transmission from critically ill patients appears to be diminished through SDD use.
authors.affiliation: Department of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. phjvdvoort@wxs.nl
authors.forename: P H
authors.initials: PH
authors.lastname: van der Voort
authors.forename: R W
authors.initials: RW
authors.lastname: van der Hulst
authors.forename: D F
authors.initials: DF
authors.lastname: Zandstra
authors.forename: A
authors.initials: A
authors.lastname: van der Ende
authors.forename: J
authors.initials: J
authors.lastname: Kesecioglu
authors.forename: A A
authors.initials: AA
authors.lastname: Geraedts
authors.forename: G N
authors.initials: GN
authors.lastname: Tytgat
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D001944:Breath Tests; D003091:Colistin / Q000627:therapeutic use; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission*; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission*; D016480:Helicobacter pylori; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017758:Infectious Disease Transmission, Patient-to-Professional; D009741:Nursing Staff, Hospital; D015995:Prevalence; D013272:Stomach Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D014031:Tobramycin / Q000627:therapeutic use
chemical_list: D000666:Amphotericin B; D014031:Tobramycin; D003091:Colistin