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抗生素使用和医院感染接触可作为 0-2 岁儿童感染暴露的替代指标,与传染性单核细胞增多症的风险相关。

Antimicrobials use and infection hospital contacts as proxies of infection exposure at ages 0-2 years and risk of infectious mononucleosis.

机构信息

Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark.

Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.

出版信息

Sci Rep. 2023 Dec 1;13(1):21251. doi: 10.1038/s41598-023-48509-3.


DOI:10.1038/s41598-023-48509-3
PMID:38040892
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10692188/
Abstract

Infectious mononucleosis (IM) often results from late primary infection with Epstein-Barr virus (EBV). Exposure to EBV at ages 0-2 years from, e.g., siblings therefore protects against IM. Using Danish registers, we therefore followed children born in 1997 through 2015 from age 3 years for a hospital contact with an IM diagnosis as outcome with the number of antimicrobial prescriptions filled before age 3 years as a proxy of infection pressure and the main exposure in stratified Cox regressions. The main analyses used sibships as strata primarily to adjust for health-seeking behaviour with further possible adjustments for age, sex, calendar period and sibship constellation. In these analyses we followed 7087 children, exposed on average to 3.76 antimicrobials prescriptions. We observed a crude hazard ratio for IM per unit increase in cumulative antimicrobial use of 1.00 (95% confidence interval 0.99, 1.02), with similar results in adjusted analyses. The hypothesis that children with the largest use of antimicrobials at ages 0-2 years would subsequently have the lowest risk of IM within a sibship was not corroborated by the data. Furthermore, sibship-matched analyses provided no support for some common early-life immune system characteristics being predictive of IM.

摘要

传染性单核细胞增多症(IM)通常由 EBV 原发感染晚期引起。例如,0-2 岁时与兄弟姐妹接触 EBV 可预防 IM。因此,我们利用丹麦的注册资料,从 1997 年至 2015 年出生的儿童中,以 3 岁为起点,随访至其首次因 IM 住院的年龄,以 3 岁前的抗生素处方数量作为感染压力的替代指标,并在分层 Cox 回归中作为主要暴露因素。主要分析以同胞关系为分层因素,主要用于调整因健康寻求行为而导致的偏倚,进一步可能还会调整年龄、性别、日历时间和同胞关系模式。在此分析中,我们共随访了 7087 名儿童,平均暴露于 3.76 种抗生素处方。结果显示,抗生素累计使用量每增加一个单位,IM 的风险比为 1.00(95%置信区间 0.99,1.02),调整分析后结果相似。抗生素使用量最大的儿童在同胞关系中随后 IM 风险最低的假设,并未得到数据的证实。此外,同胞匹配分析并未为某些常见的早期免疫系统特征预测 IM 提供支持。

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[1]
Antimicrobials use and infection hospital contacts as proxies of infection exposure at ages 0-2 years and risk of infectious mononucleosis.

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[2]
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[3]
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[4]
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[6]
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引用本文的文献

[1]
Associations between past infectious mononucleosis diagnosis and 47 inflammatory and vascular stress biomarkers.

Sci Rep. 2025-4-2

[2]
Risk of infectious mononucleosis is not associated with prior infection morbidity.

Front Epidemiol. 2025-3-12

[3]
Knowledge mapping of childhood infectious mononucleosis: a bibliometric analysis for the twenty-first century.

J Health Popul Nutr. 2025-2-17

本文引用的文献

[1]
Urgency and necessity of Epstein-Barr virus prophylactic vaccines.

NPJ Vaccines. 2022-12-9

[2]
Childcare attendance and risk of infections in childhood and adolescence.

Int J Epidemiol. 2023-4-19

[3]
Siblings reduce multiple sclerosis risk by preventing delayed primary Epstein-Barr virus infection.

Brain. 2023-5-2

[4]
Childcare attendance and risk of infectious mononucleosis: A population-based Danish cohort study.

PLoS One. 2021

[5]
Viral pneumonia in Danish children.

Dan Med J. 2021-7-12

[6]
The familial risk of infection-related hospitalization in children: A population-based sibling study.

PLoS One. 2021

[7]
Maternal antibiotic use during pregnancy and asthma in children: population-based cohort study and sibling design.

Eur Respir J. 2021-1

[8]
Epidemiology of Epstein-Barr virus infection and infectious mononucleosis in the United Kingdom.

BMC Public Health. 2020-6-12

[9]
Predictors of Epstein-Barr virus serostatus and implications for vaccine policy: A systematic review of the literature.

J Glob Health. 2020-6

[10]
Primary Epstein-Barr virus infection with and without infectious mononucleosis.

PLoS One. 2019-12-17

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