Carriage and its influencing factors of Staphylococcus aureus among kindergarten children
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摘要:
目的 了解幼儿园儿童金黄色葡萄球菌(金葡菌)的携带状况及其影响因素。 方法 本研究采用多阶段分层整群抽样方法,抽取柳州市六所幼儿园的1 702名健康儿童,进行鼻拭子采样并分离鉴定金葡菌。各组金葡菌携带率的比较采用χ2检验,金葡菌携带影响因素的多因素分析采用Logistic回归分析模型。 结果 儿童鼻腔金葡菌携带率为16.27%,多因素Logistic回归分析模型分析显示,年龄增长(4岁组OR=1.72,5岁组OR=2.68,6岁组OR=2.95,7岁组OR=4.58)、抗生素服用史(OR=1.44)和皮肤软组织感染史(OR=1.34)是金葡菌携带的危险因素,鼻腔携带肺炎链球菌(OR=0.17)是金葡菌携带的保护因素。 结论 年龄增长、有抗生素服用史和有皮肤软组织感染史是幼儿园儿童金葡菌携带的重要危险因素。 Abstract:Objective To master the carriage rate and its influencing factors of Staphylococcus aureus (S. aureus) in kindergarten children. Methods A multi-stage stratified cluster sampling method was used to sample 1 702 healthy children from six kindergartens in Liuzhou City. Nasal swabs were taken and tested for S. aureus. Chi-squared test was used to test carriage rates between groups, and logistic regression was used to analyze the effects of multiple influencing factors. Results The nasal carriage rate of S. aureus in children was 16.27%. Multivariate logistic regression analysis showed that age (OR=1.72 for children aged 4 years, OR=2.68 for children aged 5 years, OR=2.95 for children aged 6 years, and OR=4.58 for children aged 7 years), having history of antibiotic use (OR=1.44), and having history of skin and soft tissue infection (OR=1.34) were risk factors for S. aureus carriage, while the nasal carriage of Streptococcus pneumoniae (OR=0.17) was a protective factor. Conclusions Older age, history of antibiotic use and history of skin and soft tissue infection are important influencing factors for children S. aureus carriage. -
Key words:
- Children /
- Staphylococcus aureus /
- Influencing factors
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表 1 不同特征儿童的金葡菌携带率的比较
Table 1. Comparison of S. aureus carriage rate in children with different characteristics
影响因素 观察人数 金葡菌
携带人数金葡菌
携带率(%)χ2值 P值 性别 0.05 0.822 男 883 142 16.08 女 819 135 16.48 年龄(岁) 31.71a < 0.001 ≤3 190 13 6.84 4 431 52 12.06 5 463 82 17.71 6 519 102 19.65 7 99 28 28.28 民族 1.31 0.252 汉族 1 104 188 17.03 其他 598 89 14.88 幼儿园类型 0.67 0.414 公立 1 007 170 16.88 私立 695 107 15.40 地区 0.01 0.990 市区 620 101 16.29 郊区 1 082 176 16.27 同住人口数(人) 2.56 0.109 ≤3 421 58 13.78 >3 1 281 219 17.10 鼻腔携带肺炎链球菌 32.73 < 0.001 无 1 478 270 18.27 有 224 7 3.13 注:a表示采用趋势χ2检验。 表 2 社区、医院相关因素与儿童携带金葡菌关系
Table 2. Relation between community and hospital factors and S. aureus carriage in children
影响因素 观察人数 金葡菌
携带人数金葡菌
携带率(%)χ2值 P值 锻炼频率(次/周) 2.56 0.465 < 1 212 36 16.98 1 611 90 14.73 2~ 666 110 16.52 ≥4 213 41 19.25 洗澡频率 0.81 0.369 每天洗 1 649 266 16.13 非每天洗 53 11 20.75 近1年门诊就诊史 1.35 0.246 有 1 468 245 16.69 无 234 32 13.68 近1年住院史 0.01 0.979 有 110 18 16.36 无 1 592 259 16.27 近1年手术史 0.01 0.992 有 49 8 16.33 无 1 653 269 16.27 近1年抗生素服用史 6.18 0.013 有 1 249 220 17.61 无 453 57 12.58 近1年皮肤软组织感染史 6.00 0.014 有 609 117 19.21 无 1 093 160 14.64 近1年皮肤过敏疾病史 3.30 0.069 有 332 65 19.58 无 1 370 212 15.47 近1年家人皮肤感染史 0.57 0.452 有 287 51 17.77 无 1 415 226 15.97 近1年家人住院史 6.44 0.011 有 297 63 21.21 无 1 405 214 15.23 表 3 幼儿园儿童携带金葡菌的多因素Logistic回归分析模型
Table 3. Multivariate logistic regression analysis of S. aureus carriage in kindergarten children
影响因素 β值 sx Z值 OR(95% CI)值 P值 年龄(岁) ≤3 1.00 4 0.54 0.56 1.65 1.72(0.90~3.25) 0.099 5 0.98 0.84 3.12 2.68(1.44~4.97) 0.002 6 1.08 0.92 3.48 2.95(1.60~5.43) < 0.001 7 1.52 1.69 4.14 4.58(2.23~9.43) < 0.001 鼻腔携带肺炎链球菌 无 1.00 有 -1.80 0.06 -4.58 0.17(0.08~0.36) < 0.001 近1年抗生素服用史 无 1.00 有 0.36 0.24 2.20 1.44(1.04~1.98) 0.028 近1年皮肤软组织感染史 无 1.00 有 0.29 0.18 2.10 1.34(1.02~1.75) 0.036 近1年皮肤过敏疾病史 无 1.00 有 0.13 0.19 0.76 1.13(0.82~1.56) 0.444 近1年家人住院史 无 1.00 有 0.31 0.23 1.88 1.37(0.99~1.89) 0.060 -
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