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Abstract
Background: The epidemiology of Helicobacter pylori is still under investigation. It is postulated that the human stomach is the natural reservoir and that spread occurs by oral-oral or fecal-oral transmission. The aim of this study was to determine whether medical staff, especially endoscopy unit personnel, are at an increased risk of acquiring H. pylori infection. Methods: An enzyme-linked immunosorbent assay technique was used to detect circulating H. pylori IgG antibodies in 1050 medical staff from 16 hospitals in Shanghai, including 125 GI endoscopists, 45 endoscopy unit nurses, 71 gastroenterologists not doing endoscopy, 105 nurses working in gastroenterology wards, 417 internists, and 287 general nurses. This group was compared with an age-matched population obtained from the same urban area of the city. Results: The overall prevalence of H. pylori infection in total medical staff was 70.0%, compared to 44.6% in general population (P < 0.0001). Age-adjusted comparisons between subgroups of medical staff were made. The prevalence of H. pylori in GI endoscopists was 82.4%, which is significantly higher than 66.4% in internists and 65.8% in general nurses (all, P < 0.01) but not significantly different from 77.7% in endoscopy unit nurses or from 74.2% in nurses working in gastroenterology wards (all, P > 0.05). Further analysis did not show any significant difference in the prevalence of H. pylori between other subgroups. The prevalence of H. pylori infection in GI endoscopists increased with the number of years of practice. Conclusions: Medical staff, especially endoscopy unit personnel, are at increased risk of infection with H. pylori. These findings strongly suggest the medical practice and endoscopy procedures are risk factors for H. pylori infection and support person-to-person transmission in this setting, probably from patients to medical staff.