Riordan T, Cartwright K, Andrews N, Stuart J, Burris A, Fox A, Borrow R, Douglas-Riley T, Gabb J, Miller A
Public Health Laboratory, Church Lane, Heavitree, Exeter.
Epidemiol Infect. 1998 Dec;121(3):495-505. doi: 10.1017/s0950268898001496.
Meningococcal acquisition is a prerequisite for invasive disease. Three hundred and eleven male marine commando recruits were studied throughout 29 weeks of basic training to identify factors influencing meningococcal carriage and acquisition including troop number, season, smoking, respiratory infection, antibiotic usage and nasopharyngeal bacterial interference flora. A high carriage rate on entry to training (118/311, 37.9%) and subsequent sustained high rates of meningococcal acquisition were found. Of the potential factors examined, only active and passive smoking were found to be associated significantly with meningococcal carriage on entry. The association between active smoking and meningococcal carriage was dose-dependent, with odds ratios (OR) of 2.2 (95% CIs 1.0-4.8) and 7.2 (95% CIs 2.3-22.9) for light and heavy smokers respectively. Passive smoking predisposed independently to carriage (OR 1.8, 95% CIs 1.1-3.0). Active and passive smoking combined to give an attributable risk for meningococcal carriage of 33%. In contrast, despite a high and sustained rate of meningococcal acquisition in the study population, none of the risk factors investigated, including active smoking, was associated significantly with meningococcal acquisition. No cases of meningococcal disease occurred during the 16-month study period. Therefore smoking may increase the duration of meningococcal carriage rather than the rate of acquisition, consistent with the increased risk of meningococcal disease from passive as opposed to active smoking. Public health measures that reduce the prevalence of smoking should reduce the risk of meningococcal disease.
脑膜炎球菌感染是侵袭性疾病的先决条件。在29周的基础训练期间，对311名男性海军陆战队新兵进行了研究，以确定影响脑膜炎球菌携带和感染的因素，包括部队人数、季节、吸烟、呼吸道感染、抗生素使用和鼻咽部细菌干扰菌群。新兵入伍时脑膜炎球菌携带率较高（118/311，37.9%），随后脑膜炎球菌感染率持续居高不下。在所研究的潜在因素中，仅发现主动吸烟和被动吸烟与新兵入伍时脑膜炎球菌携带显著相关。主动吸烟与脑膜炎球菌携带之间的关联呈剂量依赖性，轻度吸烟者和重度吸烟者的优势比（OR）分别为2.2（95%可信区间1.0 - 4.8）和7.2（95%可信区间2.3 - 22.9）。被动吸烟独立增加携带风险（OR 1.8，95%可信区间1.1 - 3.0）。主动吸烟和被动吸烟共同导致脑膜炎球菌携带的归因风险为33%。相比之下，尽管研究人群中脑膜炎球菌感染率高且持续，但所调查的风险因素，包括主动吸烟，均与脑膜炎球菌感染无显著关联。在16个月的研究期间未发生脑膜炎球菌病病例。因此，吸烟可能增加脑膜炎球菌携带的持续时间而非感染率，这与被动吸烟而非主动吸烟导致脑膜炎球菌病风险增加相一致。降低吸烟流行率的公共卫生措施应能降低脑膜炎球菌病的风险。
