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Scott L. Wilhoite, MD; Donald A. Ferguson, Jr, PhD; David R. Soike, MD; John H. Kalbfleisch, PhD; Eapen Thomas, MD

Arch Intern Med. 1993;153(6):708-712.

Abstract
Background
Numerous studies have suggested that Helicobacter pylori infection in asymptomatic subjects is transmitted from person to person. Its prevalence is higher in the institutionalized setting. If that is the case, persons involved in patient care should have a higher prevalence of the infection.

Methods
We estimated the prevalence of H pylori antibodies among groups of asymptomatic medical and nursing staff and compared them with volunteer blood donors of similar age and sex.

Results
One hundred fifty-eight nurses and aides, 59 residents, 46 senior medical students, and 22 senior nursing students were enrolled in this study. Serum samples were tested for IgG antibodies against H pylori by enzymelinked immunosorbent assay. Sixty-two (39%) of 158 nurses were found to be positive for antibodies to H pylori compared with 114 (26%) of 441 specimens from the blood donor group. Within the youngest age group (20 to 34 years), 13 (25%) of 51 nurses were positive for H pylori antibodies compared with 19 (13%) of 143 agematched serum samples from the blood donor group. Within the middle age group (35 to 49 years), 32 (39%) of 83 nurses were positive for H pylori antibodies vs 43 (26%) of 167 age-matched blood donors. In the oldest age group (>50 years), 17 (71%) of 24 nurses were positive for H pylori antibodies compared with 52 (40%) of 131 age-matched blood donors. Twenty-three (27%) of 86 nurses with 1 to 15 years of occupational exposure were positive for H pylori antibodies compared with 40 (56%) of 72 nurses with more than 15 years of occupational exposure.

Conclusions
Nurses have an increased prevalence of H pylori antibodies that is significantly higher than the comparable prevalence of volunteer blood donors and is evident in the youngest age group. In addition, the increased prevalence is related to a longer duration of patient exposure in the nursing group.

(Arch Intern Med. 1993;153:708-712)

Author Affiliations
From the Departments of Internal Medicine (Gastroenterology) (Drs Wilhoite and Thomas), Microbiology (Dr Ferguson), Pathology (Dr Soike), and Division of Biometry and Medical Computing in the Section of Medical Education (Dr Kalbfleisch), James H. Quillen College of Medicine, East Tennessee State University, Veterans Affairs Medical Center, and Johnson City (Tenn) Medical Center Hospital.

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