The pathogenesis of acute gastric ulceration of the ICU patients is still unclear and whether Helicobacter pylori (HP) plays a role in pathogenesis is not known [1,2]. In this study, we aimed to detect the presence of HP colonization in stools and the importance of the HP positivity of the ICU staff in spread of infection.

The study included 52 patients, treated in the ICU and 40 healthcare staff from ICU of Department of Anaesthesia and 40 from the ICU of the other departments. Presence of HP antigen was assessed by using Helicobacter pylori Stool Antigen (HpSA) test (Primer Platinum HpSA; Meridian Diagnostic, Cincinnati, USA) in the first 24-48 hours and at the end of a week after admission for the patients and only once from the medical staff. The antigen titers were compared between the ICU staff and others based on the multiple factors.

The hospitalization in ICU was a significant factor in HP antigen positivity. The incidence of HP positivity in ICU staff was higher than the others (P < 0.05). The antigen titers were also higher in ICU staff than the other staff and this difference was statistically significant (P < 0.05). The antigen titers were also well correlated with their duration of working in ICU (P < 0.05). Presence of a high incidence of HP infections in ICU patients lead us to the thought that HP might be suggested as one of the causative agents in nosocomial infections. High antigen titers in ICU staff suggested that transmission by oral-oral or fecal-oral routes might be possible because they often exposed to secretions of patients such as feces, urine and saliva [1,3].

In the critically ill patients, acute ulcer prophylaxis was caused by HP infection. This study also showed the importance of knowledge of a new nosocomial causative agent for ICU staff and its probable spreading ways of oral-oral or fecal-oral.