Persistent carriage of Streptococcus pneumoniae and its influencing factors among children in kindergartens
扫码查看
点击上方二维码区域，可以放大扫码查看
原文链接
NETL
NSTL
万方数据
目的 探索幼儿园儿童肺炎链球菌的持续携带状况及其影响因素.方法 采用多阶段分层整群抽样方法,抽取佛山市顺德区6所幼儿园的健康儿童,对所有儿童进行3次鼻拭子采样并分离鉴定肺炎链球菌.采用单因素x2检验和多因素logistic回归分析模型分析儿童肺炎链球菌持续携带的影响因素.鉴于3次采样的班级内阳性数具有不独立性且相关性较强,本研究分别拟合3个多因素logistic回归分析模型(即模型1～3).除"班级内阳性人数"变量外,3个模型在控制混杂因素及分析方法上保持一致.运用随机森林模型对肺炎链球菌持续携带相关的影响因素进行重要性排序.结果 儿童肺炎链球菌持续携带率为6.6％.模型1的多因素logistic回归分析结果表明:班级内阳性人数越多,肺炎链球菌持续携带率越高且呈现单调递增趋势.以0～＜4人阳性组为对照,其他组的 OR 分别为 2.35(95％CI:1.12～4.90,P=0.023)、5.86(95％CI:2.75～12.49,P＜0.001)、9.43(95％CI:4.68～19.02,P＜0.001);随着儿童年龄的增长,肺炎链球菌持续携带率呈现递减趋势.以 0～＜3 岁组为对照,其他组 OR 分别为 0.38(95％CI:0.20～0.72,P=0.003)、0.29(95％CI:0.15～0.55,P＜0.001)、0.29(95％CI:0.14～0.60,P=0.001);近 1 年内过敏性疾病史是肺炎链球菌持续携带的保护因素(OR=0.44,95％CI:0.20～0.98,P=0.045).模型2和模型3的研究结果与模型1基本一致.结论 班级内阳性人数增多是幼儿园儿童肺炎链球菌持续携带的重要危险因素;年龄的增长与近1年内过敏性疾病史是幼儿园儿童肺炎链球菌持续携带的保护因素.
Objective To explore the prevalence and influencing factors of persistent carriage of Streptococcus pneumoniae(S.pneumoniae)in kindergarten children.Methods A multi-stage stratified cluster sampling method was used in this study.Healthy children were sampled from six kindergartens in Shunde District,Foshan City.All children underwent three nasal swab samplings,followed by isolation and identification of S.pneumoniae.Univariate chi-square tests and multivariate logistic regression analy-sis models were used to analyze the factors influencing persistent carriage of S.pneumoniae in children.Given the non-independence and strong correlation of the number of positive cases within classes across three samples,this study has developed three separate multivariable logistic regression analysis models(namely,models 1 to 3).Apart from the variable"number of positive cases within the class",all three models maintain consistency in controlling for confounding factors and in the analytical methods used.A random forest model was applied to rank the importance of factors associated with persistent carriage of S.pneumoniae.Results The persistence carriage rate of S.pneumoniae in children was 6.6％.The re-sults of the multivariable logistic regression analysis in model 1 indicated that a higher number of positive cases within a class was associated with an increased rate of persistent carriage of S.pneumoniae,showing a monotonic increasing trend.Compared to the group with 0 to＜4 positive cases,the odds ratios for other groups were 2.35(95％CI:1.12-4.90,P=0.023),5.86(95％CI:2.75-12.49,P＜0.001),and 9.43(95％CI:4.68-19.02,P＜0.001),respectively.The rate of persistent carriage of S.pneumoniae decreased with increasing age.Compared to the group aged 0 to＜3 years,the odds ratios for other age groups were 0.38(95％CI:0.20-0.72,P=0.003),0.29(95％CI:0.15-0.55,P＜0.001),and 0.29(95％CI:0.14-0.60,P=0.001),respectively.A history of allergic diseases within the past year was identified as a protective factor for the persistent carriage of S.pneumoniae,with an odds ratio of 0.44(95％CI:0.20-0.98,P=0.045).The findings from models 2 and 3 were consistent with those from model 1.Conclusions An increased number of positive cases within a class is a significant risk fac-tor for the persistent carriage of S.pneumoniae among kindergarten children;whereas,an increase in age and a history of allergic diseases within the past year serve as protective factors against the persistent carri-age of S.pneumoniae in this population.
NETL
NSTL
万方数据
