天津市学校猩红热聚集疫情中A组链球菌检出情况

董晓春; 李琳; 张颖

doi:10.16835/j.cnki.1000-9817.2024286

天津市学校猩红热聚集疫情中A组链球菌检出情况

doi: 10.16835/j.cnki.1000-9817.2024286

天津市疾病预防控制中心传染病预防控制所，300011

基金项目:

天津市医学重点学科 TJYXZDXK-050A

天津市卫生健康科技项目 TJWJ2023XK030

详细信息

作者简介:
董晓春(1981-)，男，山西忻州人，硕士，主任医师，主要从事呼吸道传染病防控工作

通讯作者:
张颖，E-mail：cdczhangying@sina.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G478 R181.3⁺² R515.1
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- 被引次数: 0
出版历程
- 收稿日期: 2024-03-05
- 修回日期: 2024-07-22
- 网络出版日期: 2024-11-02
- 刊出日期: 2024-10-25

Detection of group A streptococcus in scarlet fever cluster outbreaks in schools in Tianjin City

Infectious Disease Prevention and Control Institute, Tianjin Center for Disease Control and Prevention, Tianjin (300011), China

摘要

摘要: 目的探讨学校猩红热聚集性疫情中病例同班级人员A组链球菌(GAS)的感染情况，并对影响GAS检出的相关因素进行分析，为开展猩红热防控工作提供参考。方法选择2023年天津市报告猩红热聚集性疫情的学校中有猩红热病例出现的班级，采集班级中除病例(共97例)外其他同学的咽拭子标本(共528份)开展GAS的分离和鉴定。应用条件Logistic回归对影响GAS检出的因素进行分析。结果 12起猩红热聚集疫情涉及的15个班级中，学生检出GAS总阳性率为21.02%；班级GAS阳性检出率与班级内猩红热病例数呈正相关(r=0.82，P < 0.01)。条件Logistic回归分析结果显示，被采样学生有咽痛(OR=2.53，95%CI=1.61~3.99)、扁桃体肿大(OR=1.90，95%CI=1.15~3.14)者检出GAS阳性可能性更大(P值均 < 0.05)。结论学校猩红热聚集性疫情中与病例同班的临床咽痛、扁桃体肿大的学生检出GAS的可能性更大。应关注学校猩红热聚集性疫情中咽痛、扁桃体肿大的学生，采取与病例同样的管理方式，同时对病例班级中的密切接触者判定不应局限于病例周围的学生。
- 猩红热 /
- 链球菌感染 /
- 疾病暴发流行 /
- 回归分析 /
- 儿童，学龄前
Abstract: Objective To investigate the infection status of group A streptococcus (GAS) among scarlet fever cases within the same class in schools experiencing clustering outbreaks and to analyze the factors associated with GAS detection, so as to provide a reference for the prevention and control of scarlet fever. Methods All the classes with scarlet fever cases in schools reporting the clustering outbreaks of scarlet fever in Tianjin in 2023 were selected, and a total of 528 pharyngeal swab samples were collected from other students in the class for GAS isolation and identification except for the 97 patients. Conditional Logistic regression was used to analyze the influencing factors of GAS detection. Results The overall positive rate of GAS among students in 15 classes from 12 clustering outbreaks with scarlet fever was 21.02%. There was a positive correlation between the positive rate of GAS detection in the class and the number of scarlet fever cases in the class (r=0.82, P < 0.01). The results of conditional Logistic regression analysis showed that pharyngeal pain (OR=2.53, 95%CI=1.61-3.99) and tonsillar enlargement (OR=1.90, 95%CI=1.15-3.14) of the sampled students were more likely to detect GAS positivity (P < 0.05). Conclusions In the clustered outbreak of scarlet fever in schools, students with sore throat and swollen tonsils who are in the same class as the case are more likely to be detected with GAS. During a school scarlet fever cluster outbreak, students with sore throat and swollen tonsils should be closely monitored and managed similarly to confirmed cases. At the same time, identifying close contacts in the affected class should not be restricted to those seated directly around the case.
- Scarlet fever /
- Streptococcal infections /
- Disease outbreaks /
- Regression analysis /
- Child, preschool
注释:

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表 1 被采样学生GAS阳性影响因素的Logistic回归分析(n=528)

Table 1. Logistic regression of factors influencing positive GAS among the sampled students(n=528)

自变量	β值	标准误	Wald χ²值	P值	OR值(95%CI)
性别	0.01	0.19	< 0.01	0.97	1.01(0.69~1.47)
年龄/岁	0.09	0.27	0.11	0.74	1.10(0.64~1.88)
发热	0.51	0.36	1.97	0.16	1.66(0.82~3.36)
咽痛	1.00	0.23	19.15	< 0.01	2.71(1.74~4.25)
扁桃体肿大	0.78	0.25	9.72	< 0.01	2.19(1.34~3.59)
与最近病例座位距离/m	-0.00	0.01	0.08	0.78	1.00(0.97~1.02)

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