Asymptomatic dermatophyte carriers in the households of children with tinea capitis.
Asymptomatic dermatophyte carriers in the households of children with tinea capitis.
复制标题
头癣儿童家庭中的无症状皮肤癣菌携带者。
DOI：
10.1001/archpedi.153.5.483
复制
发表时间：
1999
影响因子：
--
通讯作者：
N. Esterly
中科院分区：
文献类型：
--
作者：
A. Pomeranz;S. Sabnis;G. J. McGrath;N. Esterly
目标
目的：确定头癣患儿家庭接触者中携带者状态的患病率、携带者状态的持续时间、与携带者相关的因素以及发生临床疾病的携带者比例。
设计
横断面、队列、患病率研究。
设置
普通儿科诊所为贫穷的市中心非裔美国人提供服务。
病人
头癣患儿的家庭接触者。通过培养确定指示病例和携带者(没有感染的临床证据)。对携带者进行监测，直到他们的培养结果转为阴性，他们出现临床疾病，或经过6个月的时间。
结果
对56个指标性病例和114名接触者(50名成人和50名儿童)进行了评估。在指示病例和携带者中，98%的皮肤癣菌是托氏毛霉菌。在初次访问时，114个接触者中有18个(16%)(95%可信区间[95%CI]，10-24)是携带者，而在所研究的44个家庭中，有14个(32%)至少有一个携带者。在2个月、4个月和6个月的访问中，17人(95%CI，19-67)中有7人(41%)，15人(95%CI，4-48)中有3人(20%)，15人(95%CI，2-40)中有2人(13%)存在携带者状态。其中三家航空公司失去了后续行动。在携带者中，15人中有1人(7%)(95%可信区间，0.2-32)发生了头癣。单变量和多变量分析显示，携带者状态与年龄、性别、共用梳子或同睡无关。然而，共眠和共享梳子在接触者中很常见，分别出现在75%和78%的时间里，这使得统计上很难与我们的样本量相关联。
结论
头癣儿童的家庭接触者中无症状携带皮肤真菌的初始流行率为16%，其中41%的携带者持续2个月。32%的家庭至少有一名成员是携带者。7%的携带者出现了活动性感染。应该考虑使用抗孢子虫洗发水治疗携带者，因为它们可能会成为感染的宿主或发展为活动性疾病。共眠和分享梳子的高患病率可能是该病传播的重要因素。
OBJECTIVES
To determine the prevalence of the carrier state in household contacts in children with tinea capitis, the duration of the carrier state, factors associated with carriage, and the proportion of carriers who develop clinical disease.
DESIGN
Cross-sectional, cohort, prevalence study.
SETTING
General pediatric clinic serving an indigent, inner-city, African American population.
PATIENTS
Household contacts in children with tinea capitis. Index cases and carriers (no clinical evidence of infection) were identified by culture. Carriers were monitored until the results of their culture became negative, they developed clinical disease, or a 6-month period had elapsed.
RESULTS
Fifty-six index cases and 114 contacts (50 adults and 64 children) were evaluated. Ninety-eight percent of the dermatophytes identified in index cases and 100% in carriers were Trichophyton tonsurans. At the initial visit, 18 (16%) of 114 (95% confidence interval [95% CI], 10-24) of contacts were carriers and 14 (32%) of 44 of the families studied had at least 1 carrier. At the 2-, 4-, and 6-month visits, the carrier state persisted in 7 (41%) of 17 (95% CI, 19-67), 3 (20%) of 15 (95% CI, 4-48), and 2 (13%) of 15 (95% CI, 2-40), respectively. Three of the carriers were lost to follow-up. Of the carriers, 1 (7%) of 15 (95% CI, 0.2-32) developed tinea capitis. Univariate and multivariate analysis showed no association of carrier state to age, sex, comb sharing, or cosleeping. However, cosleeping and comb sharing were common among the contacts, occurring 75% and 78% of the time, respectively, making statistical correlation difficult with our sample size.
CONCLUSIONS
Initial prevalence of asymptomatic carriage of dermatophytes among household contacts of a child with tinea capitis was 16%, with 41% of carriers persisting up to 2 months. Thirty-two percent of families had at least 1 member who was a carrier. Seven percent of the carriers developed an active infection. Treatment of carriers with sporicidal shampoo should be considered since they may act as a reservoir for infection or develop active disease. The high prevalence of cosleeping and comb sharing may be important factors in the spread of the disease.