9至12年级学生患脑膜炎球菌病的风险因素。

Risk factors for meningococcal disease in students in grades 9-12.

作者信息

Harrison Lee H, Kreiner Carolyn J, Shutt Kathleen A, Messonnier Nancy E, O'Leary Mary, Stefonek Karen R, Lin Huai, Lynfield Ruth, Barrett Nancy L, Arnold Kathryn E, Jones Timothy F, Montero José T

机构信息

Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

出版信息

Pediatr Infect Dis J. 2008 Mar;27(3):193-9. doi: 10.1097/INF.0b013e31815c1b3a.

DOI:10.1097/INF.0b013e31815c1b3a

PMID:18277925

Abstract

BACKGROUND

Meningococcal disease is a serious problem in adolescents, including high school students. Universal immunization of adolescents with meningococcal conjugate vaccine was recently recommended. We studied risk factors for meningococcal disease in students in grades 9-12.

METHODS

This was a matched case-control study using surveillance for meningococcal disease in students in grades 9-12 in sites throughout the United States. For each case-patient, up to 4 controls were selected from the home room classroom. All subjects answered an extensive questionnaire. Logistic regression was performed to identify risk factors associated with meningococcal disease. Meningococcal isolates were characterized.

RESULTS

Of 69 eligible patients, 49 (71%) were enrolled and had at least 1 control. Isolates were available for 59 (86%) cases. Attending at least 1 barbeque or picnic [matched odds ratio (MOR): 0.26, P value = 0.003] or school dance (MOR: 0.30, P = 0.04) were independently associated with decreased risk of meningococcal disease. Male gender (MOR: 2.94, P = 0.009), upper respiratory infection symptoms (MOR: 2.43, P = 0.04), marijuana use (MOR: 4.21, P = 0.009), and nightclub/disco attendance (MOR: 3.30, P = 0.04) were associated with increased risk. Among 54 students not from Oregon (where serogroup B strains predominate) with available serogroup, 38 (73.1%) cases were potentially vaccine preventable: 18 (34.6%) serogroup C, 19 (36.5%) serogroup Y, and 1 (1.9%) serogroup W-135.

CONCLUSIONS

Certain behaviors increase the risk of meningococcal infection, whereas others are associated with decreased risk. Most meningococcal disease in high school students can be prevented if recommendations on use of meningococcal conjugate vaccine are implemented.

摘要

背景

脑膜炎球菌病在青少年中是个严重问题，包括高中生。近期建议对青少年普遍接种脑膜炎球菌结合疫苗。我们研究了9至12年级学生患脑膜炎球菌病的风险因素。

方法

这是一项配对病例对照研究，利用美国各地对9至12年级学生脑膜炎球菌病的监测。对于每例病例患者，从其所在的教室最多选取4名对照。所有受试者都回答了一份详尽的问卷。进行逻辑回归以确定与脑膜炎球菌病相关的风险因素。对脑膜炎球菌分离株进行了特征分析。

结果

69名符合条件的患者中，49名（71%）被纳入研究且至少有1名对照。59例（86%）病例有分离株可用。参加至少1次烧烤或野餐[配对比值比（MOR）：0.26，P值 = 0.003]或学校舞会（MOR：0.30，P = 0.04）与脑膜炎球菌病风险降低独立相关。男性（MOR：2.94，P = 0.009）、上呼吸道感染症状（MOR：2.43，P = 0.04）、吸食大麻（MOR：4.21，P = 0.009）以及光顾夜总会/迪斯科舞厅（MOR：3.30，P = 0.04）与风险增加相关。在54名非来自俄勒冈州（B群菌株占主导）且有可用血清群信息的学生中，38例（73.1%）病例可能可通过疫苗预防：18例（34.6%）为C群，19例（36.5%）为Y群，1例（1.9%）为W - 135群。