幼儿园儿童肺炎链球菌携带的聚集性及影响因素分析

Clustering and influencing factors of Streptococcus pneumoniae carriage among kindergarten children

目的探讨幼儿园儿童肺炎链球菌携带的聚集性及影响因素,为肺炎链球菌性疾病的预防提供科学依据。方法采用多阶段分层整群抽样的方法,对柳州市1 702名幼儿园儿童进行双侧鼻前庭拭子采样,对其家长进行问卷调查,数据分析采用卡方检验和随机效应logistic回归模型。结果幼儿园儿童鼻部肺炎链球菌携带率为13.16%(224/1 702)。聚集性分析显示:肺炎链球菌携带在班级水平的随机效应具有统计学意义(Z=2.07,P=0.038),组内相关系数为5.9%。随机效应logistic回归分析表明,5~7岁儿童的肺炎链球菌携带风险低于2~<5岁儿童(OR=0.55,95%CI:0.40~0.76,P=0.001);同住人口数≥5的儿童的肺炎链球菌携带风险高于同住人口数<5的儿童(OR=1.34,95%CI:1.01~1.79,P=0.043)。结论肺炎链球菌携带存在班级水平的聚集性;年龄和同住人口数是儿童肺炎链球菌携带的重要影响因素。

Objective To study the clustering and influencing factors of Streptococcus pneumoniae carriage among kindergarten children, and to provide a scientific basis for the prevention of pneumococcal diseases. Methods The multi-stage stratified cluster sampling method was used to collect nasal swabs via the nasal vestibule at both sides from 1 702 kindergarten children in Liuzhou, China. A questionnaire survey was performed on their parents. The chisquare test and the random effects logistic regression analysis were used to analyze data. Results The carriage rate of Streptococcus pneumoniae was 13.16%(224/1 702) among kindergarten children. The clustering analysis showed that the class-level random effect of Streptococcus pneumoniae carriage was statistically significant(Z=2.07, P=0.038), with an intraclass correlation coefficient of 5.9%. The random effects logistic regression analysis showed that the children aged 5-7 years had a lower risk of Streptococcus pneumoniae carriage than those aged 2-<5 years(OR=0.55, 95%CI: 0.40-0.76, P=0.001), and the children with ≥5 family members living together had a higher risk of Streptococcus pneumoniae carriage than those with <5 family members(OR=1.34, 95%CI: 1.01-1.79, P=0.043). Conclusions Streptococcus pneumoniae carriage shows a class-level clustering effect, and age and the number of cohabitants are important influencing factors for Streptococcus pneumoniae carriage in children.