学龄前儿童肺炎链球菌和卡他莫拉菌携带状态及影响因素分析

Co-carriage of Streptococcus pneumoniae and Moraxella catarrhalis among preschool children and its influencing factors

摘要:

目的 了解学龄前儿童肺炎链球菌和卡他莫拉菌的携带状态及影响因素。 方法 采用分层整群抽样方法抽取广东省佛山市顺德区7所幼儿园中共2 031名健康儿童为研究对象，对所有儿童进行鼻拭子采样并分离鉴定肺炎链球菌和卡他莫拉菌。分析儿童肺炎链球菌和卡他莫拉菌的不同携带状态与其人口学特征、医院/社区相关因素的关系。 结果 学龄前儿童鼻腔肺炎链球菌携带率为21.81%，卡他莫拉菌携带率为52.44%，肺炎链球菌和卡他莫拉菌的共携带率为14.87%。对应分析表明，低年龄班、外市户籍、现居住农村、居住面积小、有呼吸道感染史且无抗生素使用史、有过敏性皮肤病、无医院相关暴露史与儿童肺炎链球菌和卡他莫拉菌的共携带显著相关（P<0.05）。 结论 学龄前儿童存在肺炎链球菌和卡他莫拉菌的共携带现象；年龄小、不良的居住环境、有呼吸道感染史且无抗生素使用史、有过敏性皮肤病、无医院相关暴露史是学龄前儿童肺炎链球菌和卡他莫拉菌共携带的重要危险因素。

Abstract:

Objective To investigate the carriage status of Streptococcus pneumoniae (S. pneumoniae) and Moraxella catarrhalis (M. catarrhalis) in preschool children and the influencing factors for the carriage status. Methods The stratified cluster sampling method was used to select 2 031 healthy children from seven kindergartens in Shunde District of Foshan in Guangdong, China. Nasal swabs were collected from all children for the isolation and identification of S. pneumoniae and M. catarrhalis. The carriage status of S. pneumoniae and M. catarrhalis was analyzed in terms of its association with demographic features and hospital- and community-related factors. Results The carriage rates of S. pneumoniae and M. catarrhalis were 21.81% and 52.44%, respectively among the children. The co-carriage rate of S. pneumoniae and M. catarrhalis was 14.87%. The correspondence analysis showed that the factors such as lower grade, non-local registered residence, living in rural areas, small living area, history of respiratory tract infection but no history of antibiotic use, allergic skin diseases, and no hospital-related exposure history were significantly associated with the co-carriage of S. pneumoniae and M. catarrhalis among the children (P<0.05). Conclusions Co-carriage of S. pneumoniae and M. catarrhalis can be observed in preschool children. Young age, poor living environment, a history of respiratory tract infection but no history of antibiotic use, allergic skin diseases, and no hospital-related exposure history are important risk factors for the co-carriage of S. pneumoniae and M. catarrhalis in preschool children.