H. Pylori infection in endoscopists

R. Chulkan, M. Stemthal, C. Bodian, G. Perez- Perez, M. J. Blaser, P. M.R. Green

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Aim: Studies have suggested that endoscopists are at increased risk of H. pylori infection (Hp). This study sought to assess the prevalence of H.p. infection in endoscopists and correlate this with demographic and practice factors. Methods: Attendees at the annual NYSGE course and the fellows summer conference were enrolled. Serum was tested for Hp antibody and CagA antibody using ELISA assays. The cut-off values for positivity were 1.0 and 0.35, respectively. Data were analyzed using univariate analysis with and without stratification with respect to Hp and CagA status. Results: 144 attendees participated (44 females and 100 males). 54% were attendings, 34% were trainees, and 12% were endoscopy assistants. 52 subjects were Hp positive (36%), and 29 (20%) of these also were CagA positive. In the univariate analysis (all pts combined) the only statistically significant risk factor for Hp infection was birthplace; foreign-born subjects being twice as likely to be Hp positive (55% vs 26%, p=0.001). There was a suggestion that age >40 was associated with Hp positivity (40% vs 24%) but this did not reach statistical significance (p=0.09). There was no association between positivity and use of gloves during endoscopy. There were no significant differences found when gender, dyspeptic symptoms, use of universal precautions, and number of yrs performing endoscopy were analyzed. In the stratified analyses controlling for birthplace, there was a substantial difference in Hp positivity in different age-groups for the U.S. born subjects (9% for <40 vs 32% for >40, p=0.036) but not for the foreign-born group (47% vs 58%, p=0.48). Similarly, no difference was seen in the foreign-born group for years performing endoscopy, whereas in the U.S. born group there was a trend toward increase in likelihood of being Hp positive with increasing endoscopic experience (p=0.12). For the CagA analysis on the Hp positive subset, the foreign-born group were more likely to be CagA positive (67% vs 44%, p=0.1). Younger subjects were less likely to be CagA positive (22% for <40 vs 62% for >40, p=0.03). The use of universal precautions seemed to decrease the likelihood of being CagA positive (45% vs 70%, p=0.07) Conclusions: The major risk factor for Hp positivity in this study was birth outside the U.S. Among U.S. born participants, age and duration of endoscopic experience appeared to be pertinent risk factors. CagA positivity also was associated with foreign-birth.

Original languageEnglish (US)
Pages (from-to)AB47
JournalGastrointestinal Endoscopy
Volume45
Issue number4
DOIs
StatePublished - 1997
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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