幼儿园儿童携带金黄色葡萄球菌及其影响因素分析

陈敏琪; 王旭麟; 李文宇; 傅锦坚; 叶小华

doi:10.16462/j.cnki.zhjbkz.2021.03.021

幼儿园儿童携带金黄色葡萄球菌及其影响因素分析

doi: 10.16462/j.cnki.zhjbkz.2021.03.021

1.
510310 广州，广东药科大学公共卫生学院
2.
545001 柳州，柳州市妇幼保健院预防保健科

基金项目:

国家自然科学基金 81973069

广东省基础与应用基础研究基金 2019A1515010915

柳州市科技局科技项目 2018BJ10504

详细信息

通讯作者:
叶小华，E-mail: smalltomato@163.com

中图分类号: R179;R378.1+1
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出版历程
- 收稿日期: 2020-10-12
- 修回日期: 2021-01-11
- 刊出日期: 2021-03-10

Carriage and its influencing factors of Staphylococcus aureus among kindergarten children

1.
School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China
2.
Department of Prevention and Health Care, Liuzhou Maternity and Child Health Care Hospital, Liuzhou 545001, China

Funds:

National Natural Science Foundation of China 81973069

Guangdong Basic and Applied Basic Research Foundation 2019A1515010915

Liuzhou Science and Technology Bureau Project 2018BJ10504

More Information

Corresponding author: YE Xiao-hua, E-mail: smalltomato@163.com

摘要

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。
- 儿童 /
- 金黄色葡萄球菌 /
- 影响因素
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.
- Children /
- Staphylococcus aureus /
- Influencing factors

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图 1 幼儿园儿童年龄与金葡菌携带率的关系

Figure 1. Correlation between age and S. aureus carriage rate in kindergarten children

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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)				31.71^a	< 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。

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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

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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	s_x	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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