Liu W Z, Xiao S D, Jiang S J, Li R R, Pang Z J
Shanghai Study Group for Epidemiology of Helicobacter pylori Infection, Shanghai Institute of Digestive Disease, People's Republic of China.
Scand J Gastroenterol. 1996 Aug;31(8):749-52. doi: 10.3109/00365529609010346.
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.
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.
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.
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.
幽门螺杆菌的流行病学仍在研究中。据推测，人类胃部是其自然宿主，传播途径为口口传播或粪口传播。本研究旨在确定医务人员，尤其是内镜科室人员，感染幽门螺杆菌的风险是否增加。
采用酶联免疫吸附测定技术检测来自上海16家医院的1050名医务人员循环中的幽门螺杆菌IgG抗体，其中包括125名胃肠内镜医师、45名内镜科室护士、71名不从事内镜检查的胃肠病学家、105名在胃肠病病房工作的护士、417名内科医生和287名普通护士。将该组与来自该市同一市区的年龄匹配人群进行比较。
医务人员中幽门螺杆菌感染的总体患病率为70.0%，而普通人群为44.6%（P<0.0001）。对医务人员亚组进行了年龄调整后的比较。胃肠内镜医师中幽门螺杆菌的患病率为82.4%，显著高于内科医生的66.4%和普通护士的65.8%（均P<0.01），但与内镜科室护士的77.7%或在胃肠病病房工作的护士的74.2%无显著差异（均P>0.05）。进一步分析未显示其他亚组之间幽门螺杆菌患病率有任何显著差异。胃肠内镜医师中幽门螺杆菌感染的患病率随从业年限增加而升高。
医务人员，尤其是内镜科室人员，感染幽门螺杆菌的风险增加。这些发现强烈表明医疗操作和内镜检查程序是幽门螺杆菌感染的危险因素，并支持在这种情况下的人传人传播，可能是从患者传给医务人员。
