柳州市幼儿园儿童金黄色葡萄球菌携带聚集性分析

李文宇; 陈敏琪; 王旭麟; 傅锦坚; 徐少林; 叶小华

doi:10.16835/j.cnki.1000-9817.2021.06.024

柳州市幼儿园儿童金黄色葡萄球菌携带聚集性分析

doi: 10.16835/j.cnki.1000-9817.2021.06.024

1.
广东药科大学公共卫生学院流行病与卫生统计学系, 广州 510310
2.
柳州市妇幼保健院预防保健科与体检科

基金项目:

国家自然科学基金项目 81973069

广东省基础与应用基础研究基金项目 2019A1515010915

柳州市科技局科技项目 2018BJ10504

详细信息

作者简介:
李文宇(1996-)，男，广东惠州人，在读硕士，主要研究方向为传染病流行病学

通讯作者:
叶小华，E-mail：smalltomato@163.com

中图分类号: R 446.5 G 627.8 R 725.1
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- 被引次数: 0
出版历程
- 收稿日期: 2020-11-05
- 修回日期: 2021-01-03
- 网络出版日期: 2021-06-22
- 刊出日期: 2021-06-25

Clustering of Staphylococcus aureus carriage among kindergarten children in Liuzhou

1.
Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou(510310), China

摘要

摘要: 目的探讨柳州市幼儿园儿童金黄色葡萄球菌(金葡菌)携带的聚集性及影响因素，为预防和控制金葡菌在学校儿童中的传播提供重要依据。方法 2018年4—6月，对柳州市分层整群抽取的1 702名幼儿园儿童进行双侧鼻拭子采样，对其家长进行问卷调查，采用随机效应Logistic回归分析金葡菌携带的聚集性及影响因素。结果儿童金葡菌携带率为16.3%(277/1 702)。随机效应Logistic回归分析表明，金葡菌携带在班级水平的随机效应具有统计学意义(Z=2.12，P<0.01)，提示具有班级聚集性；影响因素分析提示，6~7岁(OR=2.18，95%CI=1.45~3.27)和5岁(OR=1.65，95%CI=1.08~2.50)儿童金葡菌携带率高于3~4岁儿童，近1年有抗生素服用史(OR=1.45，95%CI=1.05~2.01)和近1年有皮肤软组织感染史(OR=1.36，95%CI=1.04~1.79)与儿童金葡菌携带均呈正相关(P值均<0.05)。结论幼儿园儿童金葡菌携带存在明显的班级聚集性，年龄、抗生素服用史和皮肤软组织感染是影响儿童金葡菌携带的重要影响因素。
- 葡萄球菌, 金黄色 /
- 回归分析 /
- 儿童 /
- 感染
Abstract: Objective To explore clustering and risk factors of Staphylococcus aureus (S. aureus) carriage among kindergarten children in Liuzhou. Methods Two-sided nasal swabs were collected from 1 702 children in Liuzhou from April to June 2018. Parents of all the children were investigated by questionnaires. The random-effect Logistic regression was used to analyze the clustering and risk factors of S. aureus carriage. Results The carriage rate of S. aureus among kindergarten children was 16.3%. The random-effect Logistic regression model indicated that the class-level random effect of S. aureus carriage among children was statistically significant(Z=2.12, P<0.01). Children aged 6 to 7 years (OR=2.18, 95%CI=1.45-3.27) and 5 years (OR=1.65, 95%CI=1.08-2.50) had higher carriage rates of S. aureus than those aged 3-4 years. The history of antibiotic using (OR=1.45, 95%CI=1.05-2.01) and skin and soft tissue infections (OR=1.36, 95%CI=1.04-1.79) in the previous year were risk factors of S. aureus carriage among children. Conclusion The class-level clustering of S. aureus carriage is observed in healthy children. Age, history of antibiotic usage and history of skin and soft tissue infections are associated with risk of S. aureus carriage among preschool children.
- Staphylococcus aureus /
- Regression analysis /
- Child /
- Infection

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表 1 不同组别儿童金葡菌携带两水平零模型分析

Table 1. Two-level zero model of S.aureus carriage in children with different characteristics

分层变量	人数	固定效应				随机效应
分层变量	人数	截距	标准误	Z值	P值	效应值	标准误	Z值	P值	ICC/%
性别
男	883	-1.78	0.14	-12.95	< 0.01	0.38	0.20	1.84	0.06	10.4
女	819	-1.77	0.14	-12.40	< 0.01	0.43	0.20	2.10	0.05	11.6
年龄/岁
3~4	621	-2.36	0.25	-9.61	< 0.01	0.88	0.49	1.78	0.08	21.1
5	463	-1.60	0.16	-10.18	< 0.01	0.16	0.17	0.93	0.35	4.5
6~7	618	-1.35	0.12	-11.20	< 0.01	0.09	0.10	0.93	0.35	2.8
地区
市区	620	-1.67	0.13	-12.81	< 0.01	0.07	0.11	0.67	0.50	2.1
郊区	1 082	-1.85	0.17	-10.92	< 0.01	0.63	0.26	2.42	0.16	16.1
学校类型
公立	1 007	-1.71	0.13	-12.85	< 0.01	0.28	0.15	1.87	0.06	7.8
私立	695	-1.88	0.19	-9.82	< 0.01	0.53	0.26	2.00	0.05	13.8
合计	1 702	-1.78	0.11	-15.95	< 0.01	0.38	0.14	2.76	0.01	10.4

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表 2 儿童金葡菌携带影响因素两水平Logistic回归模型分析(n=1 702)

Table 2. Two-level Logistic model of influencing factors of S.aureus carriage in children(n=1 702)

截距与自变量	β	标准误	Z值	P值	OR(OR值95%CI)
截距	-2.58	0.21	-12.12	< 0.01	0.08(0.05~0.12)
年龄/岁
3~4					1.00
5	0.50	0.21	2.32	0.02	1.65(1.08~2.50)
6~7	0.78	0.21	3.73	< 0.01	2.18(1.45~3.27)
近1年抗生素服用史
无					1.00
有	0.37	0.16	2.26	0.02	1.45(1.05~2.01)
近1年皮肤软组织感染史
无					1.00
有	0.31	0.14	2.25	0.03	1.36(1.04~1.79)
随机部分
水平2方差	0.22	0.10	2.12	0.03
水平1尺度参数	1.00	-	-	-

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