四川省人感染猪链球菌病危险因素的匹配病例对照研究

Matched case-control study for risk factors of human Streptococcus suis infection in Sichuan province, China

目的探讨人感染猪链球菌病的危险因素。方法采取1:M匹配的病例对照研究。对疫情早期发病的29例人感染猪链球菌患者及其家属、邻居和一起处理过病(死)猪的个体共147名匹配对照进行问卷调查。调查的危险因素重点是与病(死)猪及其制品的接触方式。统计分析采用条件logistic回归方法。结果多因素分析结果显示,病前一周内曾屠宰过(OR=11.978,95%CI: 3.355～42.756)和洗切加工过(OR=3.008,95%CI:1.022～8.849)病(死)猪是发病的主要危险因素。估计屠宰和洗切加工暴露的归因危险度百分比分别为91.65%和66.76%。在研究人群中,喂养、销售、埋葬和食用等暴露因素不是发病的危险因素。结论屠宰和洗切加工病(死)猪是人感染猪链球菌病的重要危险因素。

Objective To study the potential risk factors of human infecting with Streptococcus suis. Methods 1 ： M matched case-control study was conducted. 29 human cases of Streptococcus suis infection in the early phase were included in the case group, Patients＇ family members, neighbors and peoples who had worked together with patients to handle deceased or sick pigs in the last week were recruited as matched controls. There were 147 controls in total. Both cases and controls received questionnaire investigation including the ways to contact sick/dead pigs. Conditional logistic regression was employed to analyze matching data. Results According to the results of multivariate analysis, slaughtering （ OR = 11. 978,95 % CI ： 3. 355-42. 756）, carcasses cutting and processing （ OR = 3. 008,95 % CI ： 1. 022- 8.849） sick/dead pigs were associated with cases related to human Streptococcus suis infection. The attributable risk proportion were 91.65 % and 66.76% respectively. The other types of exposures to sick/ dead pigs, including feeding, selling, burying and eating, were not associated with the human Streptococcus suis infection in our study population. Conclusion Slaughtering, carcasses cutting and processing sick/dead pigs were important risky behavior for humans to be infected by Streptococcus suis.