PREVALENCE OF HELICOBACTER-PYLORI IN RESPIRATORY PHYSICIANS PERFORMING BRONCHOSCOPY - A COMPARISON WITH GASTROENTEROLOGISTS USING THE CARBON-13 UREA BREATH TEST

Background. The mode of transmission of Helicobacter pylori is unclear , but it has been shown that gastroenterologists are at a greater risk of acquiring the infection when performing endoscopy. The current stu dy was designed to assess the risk H. pylori infection in respiratory physicians performing bronchoscopy compared to an at-risk group of gas troenterologists. We were interested in identifying whether the oral c avity is important in the transmission of H. pylori. Materials and Met hods. Respiratory physicians and gastroenterologists in southern Engla nd and Wales were invited to participate in the study. Medical, person al, and professional details were recorded, and H. pylori status was e stablished using a carbon 13 urea breath test. Results. The study incl uded 30 gastroenterologists and 30 respiratory physicians. The groups were similar for age (mean age, 46.2 years [SD 8.7] and 43.9 years [SD 8.5], respectively), number of years in practice (mean, 16.1 [6.8] an d 13.2 [5.5], respectively), amount of Third-World travel, and glove a nd drug use (antacids, Ha antagonists, proton pump inhibitors, promoti lity agents, and bismuth). The prevalence of upper gastrointestinal sy mptoms (indigestion, heartburn, abdominal pain) and history of previou s peptic ulcer or hiatus hernia were similar for both groups. Fifteen of thirty gastroenterologists and three of thirty respiratory physicia ns had positive breath tests (chi square, p < .001, 1 df). There was n o relation between age and H. pylori status. Within the group of gastr oenterologists, performance of endoscopy without gloves for longer tha n 7 years was associated with an increased prevalence of infection (> 7 years, 11 of 15 breath-test-positive; < 7 years, 4 of 15 breath-test -positive [chi square, p = .01, 1 df]). Conclusions. Gastroenterologis ts in this study appeared to be at risk of infection, whereas respirat ory physicians are not. Gastroenterologists who wear gloves during end oscopy appear to be at lower risk of H. pylori infection.