Helicobacter pylori infection: further evidence for the role of feco-oral transmission.
BACKGROUND
Helicobacter pylori infection is recognized as a major cause of chronic digestive diseases with a major public health impact, yet the knowledge of transmission pathways is limited. We studied the transmission in employees taking care of institutionalized persons with mental disabilities with a documented high prevalence of H. pylori.


METHODS
Six hundred and seventy-one health-care workers were screened for H. pylori serology. For each employee, information was collected on age, sex, father's and mother's education level, number of household members and number of children sleeping in the same bedroom during childhood, as well as lifestyle factors such as smoking and tropical journeys and occupational exposure data such as type of contact with inhabitants (changing napkins with stools, washing inhabitants, feeding inhabitants, personal contact) and seniority in the institution.


RESULTS
Seroprevalence for H. pylori increased significantly with age. In univariate analysis, risk factors for H. pylori positivity were (age-adjusted): father's education, mean length of employment, smoking, contact with fecal materials of inhabitants, washing and feeding of inhabitants. Controlling for confounders, in multiple logistic regression analysis, only fecal contact remained as a significant risk factor for H. pylori infection.


CONCLUSIONS
In health-care workers caring for a population with a high prevalence of H. pylori infection, there is an association with fecal transmission. This, however, does not rule out the possibility of other ways of transmission.
De Schryver
Antoon
A
IDEWE Occupational Health Services, Leuven, Belgium. antoon.deschryver@idewe.be
Van Winckel
Myriam
M
Cornelis
Kathleen
K
Moens
Guido
G
Devlies
Gery
G
De Backer
Guy
G
D000328:Adult; D000488:Allied Health Personnel; D001530:Belgium / Q000453:epidemiology; D018562:Disease Transmission, Infectious; D005220:Fathers / Q000193:education; D006281:Health Occupations; D016481:Helicobacter Infections / Q000097:blood* / Q000453:epidemiology* / Q000635:transmission*; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D008875:Middle Aged; D018802:Patient-Centered Care; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012907:Smoking; D013997:Time Factors