Collet J P, Burtin P, Floret D
Unité de pharmacologie clinique, université Claude-Bernard, Lyon.
Rev Prat. 1992 Sep 15;42(14):1797-803.
High proximity in daycare centers is a well established risk factor for upper respiratory tract infections as well as Haemophilus influenza meningitis. Many studies have also reported the development of gastroenteritis as well as hepatitis A outbreaks in daycare centers; however, because of lack of controls, these studies do not provide enough information about the excess of risk attributable to daycare attendance. Main risk factors such as age, or seasons, are still very important in daycare centers and studies have also shown that a protection occurs rapidly after the beginning of attendance, may be in relation to the stimulation of the non-specific immunity. All these results do not provide enough data to implement a rational intervention project. More studies have to be carried out to assess the long term consequences (at school age for instance) of these infections. In order to make a rational decision regarding daycare attendance, it is important to have a global assessment of all the effects related to attendance (which are numerous and sometimes opposite); studies focusing on a single aspect of daycare attendance, or on its short term effect, may result in partial and misleading conclusions.
日托中心人员高度密集是导致上呼吸道感染以及流感嗜血杆菌脑膜炎的一个公认风险因素。许多研究还报告了日托中心发生的肠胃炎以及甲型肝炎暴发情况；然而，由于缺乏对照，这些研究并未提供足够信息来说明日托中心导致的额外风险。年龄或季节等主要风险因素在日托中心仍然非常重要，而且研究还表明，开始入托后很快就会产生一种保护作用，这可能与非特异性免疫的刺激有关。所有这些结果都没有提供足够数据来实施合理的干预项目。必须开展更多研究，以评估这些感染的长期后果（例如在学龄期）。为了就是否送孩子去日托中心做出合理决策，全面评估与入托相关的所有影响（影响众多，有时甚至相反）非常重要；仅关注日托中心某一个方面或其短期影响的研究可能会得出片面且具有误导性的结论。
