Carriers of Neisseria meningitidis in household contacts of meningococcal disease cases in Catalonia (Spain)
Carriers of Neisseria meningitidis in household contacts of meningococcal disease cases in Catalonia (Spain)
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DOI：
10.1023/a:1015696513062
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发表时间：
2001-01-01
影响因子：
13.6
通讯作者：
Vázquez, JA
中科院分区：
文献类型：
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作者：
Cardeñosa, N;Domínguez, A;Vázquez, JA
1998年5月至1999年4月在加泰罗尼亚（西班牙）进行了一项以人群为基础的研究，以确定脑膜炎球菌病（MD）病例及其接触者中脑膜炎奈瑟菌菌株的流行率，以及MD患者密切接触者中脑膜炎球菌的流行率及其携带的风险因素。共调查了87例MD患者的364名密切接触者。在利福平化学预防开始前，由医院工作人员收集咽部样本。对于每一个接触者，完成了一份问卷调查，以获得社会人口和流行病学数据。共有61名接触者（总患病率为16.8%）为脑膜炎球菌菌株携带者（40名B、10名C、1名Z和10名不可分组的分离株）。这一流行率比一般人群（5-10%）高出2 - 3倍。在33/61例微生物学确诊病例（54%）和9/26例可能病例（35%）中，接触者携带N.在22/33例与携带者接触的确诊病例中，可以研究携带者和患者菌株的表型（血清群、血清型和血清亚型）。在14例病例中（64%），两种菌株相同，在4例病例中，仅观察到微小变化，在3例病例中，某些菌株（来自病例或其接触者）为非血清分型和非血清亚型，在1例病例中，两种分离株完全不同。双变量分析确定了脑膜炎球菌携带的五个统计学显著风险因素：年龄（5-9岁），脑膜炎球菌A + C疫苗接种，严重的家庭过度拥挤，社会阶层和大量主动吸烟（每天>20支）。多因素分析显示，在这五个变量中，只有大量主动吸烟仍然具有统计学意义时，其他因素控制。
A population-based study was carried out in Catalonia (Spain) from May 1998 to April 1999 to determine the prevalence of Neisseria meningitidis strains in meningococcal disease (MD) cases and their contacts, as well as the prevalence of meningococci in close contacts of patients with MD, and risk factors for its carriage. A total of 364 close contacts of 87 patients with MD were studied. Throat samples were collected by hospital staff before rifampicin chemoprophylaxis was begun. For each contact, a questionnaire was completed for sociodemographic and epidemiological data. A total of 61 contacts (an overall prevalence of 16.8%) were carriers of meningococcal strains (40 B, 10 C, 1 Z and 10 non-groupable isolates). This prevalence is two to three times higher than in the general population (5-10%). In 33/61 microbiologically confirmed cases (54%) and in 9/26 probable cases (35%), contacts carrying N. meningitidis were found. In 22/33 confirmed cases with carrier contacts, it was possible to study the phenotype of the carrier and patient strains (serogroup, serotype and serosubtype). In 14 cases (64%), both strains were identical, in four cases, only a minor change was observed, in three cases, some strain (from the case or from his contact) was non-serotypable and non-serosubtypable, and in one case, both isolates were completely different. Bivariate analysis identified five statistically significant risk factors for meningococcal carriage: age (5-9 years old), meningococcal A + C vaccination, severe household overcrowding, social class and heavy active smoking (>20 cigarettes a day). Multivariate analysis revealed that of these five variables, only heavy active smoking remained statistically significant when the other factors were controlled.