Centre for Academic Primary Care, NIHR School for Primary Care Research, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
School of Cellular and Molecular Medicine, Biomedical Sciences Building, University of Bristol, University Walk, Bristol, BS8 1TD, UK.
BMC Infect Dis. 2021 Dec 14;21(1):1254. doi: 10.1186/s12879-021-06954-3.
Preventing respiratory tract infections (RTIs) could have profound effects on quality of life, primary care workload, antibiotic prescribing and stewardship. We aimed to identify factors that increase and decrease RTI acquisition within Organisation for Economic Cooperation and Development (OECD) member countries.
Systematic search of Medline, Embase, Cochrane and ISI Web of Knowledge for studies conducted up to July 2020 reporting predisposing factors for community RTI acquisition. Pooled odds ratios were calculated using a random-effects model.
23 studies investigated risk factors associated with community-acquired pneumonia (n = 15); any RTI (n = 4); influenza like illness (n = 2); and lower RTI (n = 2). Demographic, lifestyle and social factors were: underweight BMI (pooled odds ratio (OR 2.14, 95% CI 1.58 to 2.70, p = 0.97); male sex (OR 1.30, 95% CI 1.27 to 1.33, p = 0.66); contact with pets (OR 1.35, 95% CI 1.16 to 1.54, p = 0.72); contact with children (OR 1.35, 95% CI 1.15 to 1.56, p = 0.05); and ex-smoking status (OR 1.57, 95% CI 1.26 to 1.88, p = 0.76). Health-related factors were: chronic liver condition (OR 1.30, 95% CI 1.09 to 1.50, p = 0.34); chronic renal condition (OR 1.47, 95% CI 1.09 to 1.85, p = 0.14); and any hospitalisation in previous five years (OR 1.64, 95% CI 1.46 to 1.82, p = 0.66).
We identified several modifiable risk factors associated with increased likelihood of acquiring RTIs in the community, including low BMI, contact with children and pets. Modification of risk factors and increased awareness of vulnerable groups could reduce morbidity, mortality and antibiotic use associated with RTIs.
CRD42019134176.
预防呼吸道感染（RTI）可以对生活质量、初级保健工作量、抗生素的使用和管理产生深远的影响。我们旨在确定在经济合作与发展组织（OECD）成员国中增加和减少 RTI 感染的因素。
系统检索了 Medline、Embase、Cochrane 和 ISI Web of Knowledge 数据库，以获取截至 2020 年 7 月报告社区获得性 RTI 感染相关易患因素的研究。使用随机效应模型计算合并的优势比。
23 项研究调查了与社区获得性肺炎（n=15）、任何 RTI（n=4）、流感样疾病（n=2）和下呼吸道感染（n=2）相关的危险因素。人口统计学、生活方式和社会因素包括：体重指数（BMI）偏低（合并优势比（OR）2.14，95%置信区间（CI）1.58 至 2.70，p=0.97）；男性（OR 1.30，95% CI 1.27 至 1.33，p=0.66）；与宠物接触（OR 1.35，95% CI 1.16 至 1.54，p=0.72）；与儿童接触（OR 1.35，95% CI 1.15 至 1.56，p=0.05）；和戒烟状态（OR 1.57，95% CI 1.26 至 1.88，p=0.76）。健康相关因素包括：慢性肝脏疾病（OR 1.30，95% CI 1.09 至 1.50，p=0.34）；慢性肾脏疾病（OR 1.47，95% CI 1.09 至 1.85，p=0.14）；以及过去五年内任何住院治疗（OR 1.64，95% CI 1.46 至 1.82，p=0.66）。
我们确定了一些与社区获得性 RTI 感染风险增加相关的可改变的危险因素，包括 BMI 偏低、与儿童和宠物接触。危险因素的改变和对弱势群体的认识提高可以减少与 RTI 相关的发病率、死亡率和抗生素使用。
PROSPERO 注册号：CRD42019134176。
