Selective decontamination of the digestive tract influences the acquisition of Helicobacter pylori among intensive care nurses

Introduction

H. pylori prevalence is increased in health care workers and in intensive care nurses. Exposure to H. pylori by gastric secretions and faeces are the main sources of transmission of pylori infection to health care workers. The routine use of selective decontamination of the digestive tract (SDD) at an intensive care unit suppresses H. pylori in critically ill patients. It was questioned whether as a consequence, a decreased exposure of H. pylori to intensive care nurses would lead to a lower prevalence of H. pylori infection in these nurses.

Methods

The H. pylori infection prevalence of intensive care from a unit using SDD routinely (group I) was compared to that of intensive care nurses from a unit not using SDD (group II). Health care workers from other departments where no SDD was used (group III) served as a control group. Both the intensive care nurses and controls were included on a voluntary basis. Persons using proton pump inhibitors were excluded. H. pylori was detected by Laser Assisted Ratio Analyser-¹³C-urea breath test (UBT).

Results

Three UBTs were unable to be processed in group I (n = 64), five in group II (n = 55) and five in group III (n = 50). The prevalence of H. pylon infection was 11% (7/61) in group 1 and 25.5% (14/50) in group II (P = 0.027, Pearson Chi-Square). In group III the prevalence of H. pylori infection was 16% (8/45) which is not significantly different from both group I and II. The mean age in the three groups was 35.9, 37.8 and 36.6 years respectively (NS).

Conclusion

The prevalence of H. pylori infection among intensive care nurses is lower in nurses from units using SDD compared to the ones from a unit not using SDD. Acquisition of H. pylori by transmission from critically ill patients appears to be diminished once SDD is used.