Determinants of <i>Helicobacter pylori</i> infection and eradication failure among healthcare workers in a high-exposure clinical setting: a single-centre retrospective cohort study in China.

Abstract

Healthcare workers (HCWs) are at potential risk of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection due to occupational exposure, yet epidemiological data in this population remain scarce. This study aimed to investigate the prevalence, risk factors, eradication efficacy and antibiotic resistance patterns of <i>H. pylori</i> infection among HCWs. Retrospective cohort study. A tertiary hospital in Beijing, China. 725 HCWs who underwent <i>H. pylori</i> testing via urea breath test between January 2020 and December 2023. Demographic characteristics, lifestyle factors, symptomatic presentations, treatment regimens and antibiotic resistance profiles were extracted from electronic medical records. Univariate analyses using χ² tests identified associations between variables, followed by multivariate logistic regression to adjust for confounders and determine independent predictors of <i>H. pylori</i> eradication failure. The overall <i>H. pylori</i> positivity rate was 22.9% (166/725). Male gender (OR=1.76, 95% CI 1.20 to 2.59) and alcohol consumption (OR=2.40, 95% CI 1.26 to 4.58) were identified as independent risk factors. Notably, <i>H. pylori</i>-positive individuals had a lower incidence of acid reflux symptoms (9.1% vs 17.3%, p=0.011). The eradication rate was 92.0% (95% CI 84.3% to 96.7%), but clarithromycin resistance reached 47.1% (95% CI 36.4% to 58.0%), with 12.8% (95% CI 6.6% to 21.5%) showing dual resistance to clarithromycin and quinolones. Targeted screening for male HCWs and alcohol users, along with bismuth-containing quadruple therapy, is recommended. High clarithromycin resistance underscores the need for local antibiotic stewardship.