Ford-Jones E L, Kitai I, Davis L, Corey M, Farrell H, Petric M, Kyle I, Beach J, Yaffe B, Kelly E, Ryan G, Gold R
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
Pediatr Infect Dis J. 1996 Jun;15(6):507-14. doi: 10.1097/00006454-199606000-00007.
To prospectively determine the rate of cytomegalovirus shedding in children and the rate of seroconversion to cytomegalovirus in providers at 38 infant-toddler day care centers in Toronto, Canada.
Urine was collected for shell vial assay in 471 children between the ages of 3 and 42 months. Providers (n = 206) were tested for the presence of cytomegalovirus antibody by latex agglutination. Of the 68 providers who were seronegative, 56 were retested approximately 1 year later.
Viruria was documented in 79 (17%) children and antibody in 67% of providers. Seropositivity was significantly related to country of birth outside Canada, presence of children at home < 5 years of age and increased household size. Seroconversion was documented in 12.5% (n = 7). Of these providers 71% worked at centers where workers never wore gloves for diaper changing vs. 33% of those who did not seroconvert (P = 0.06), and all were younger than 30 years vs. 59% of those who did not seroconvert (P = 0.04). In centers with viruria the association of seroconversion with lack of glove use was enhanced (P = 0.04). Seroconversion was marginally more likely in providers working with infants only than with infants and toddlers or with toddlers alone. Logistic regression confirmed that seroprevalence was more likely in providers who were born outside Canada, had children younger than age 5 years in the household and with an increased number of people in the household. Seroconversion was more likely if the provider worked at centers not using gloves for diaper changes, worked with infants only rather than with toddlers and infants and was < 30 years old, with each factor contributing independently to the model.
Cytomegalovirus infection is common in children and providers in Toronto day-care centers.
前瞻性地确定加拿大多伦多38家婴幼儿日托中心儿童的巨细胞病毒脱落率以及工作人员中巨细胞病毒血清转化的发生率。
收集了471名3至42个月大儿童的尿液用于空斑试验。通过乳胶凝集试验检测工作人员（n = 206）是否存在巨细胞病毒抗体。在68名血清阴性的工作人员中，约1年后对56人进行了重新检测。
79名（17%）儿童检测到病毒尿，67%的工作人员检测到抗体。血清阳性与出生于加拿大境外、家中有5岁以下儿童以及家庭规模增大显著相关。记录到血清转化的发生率为12.5%（n = 7）。在这些工作人员中，71%在工作人员换尿布时从不戴手套的中心工作，而未发生血清转化的工作人员中这一比例为33%（P = 0.06），且所有发生血清转化的工作人员年龄均小于30岁，而未发生血清转化的工作人员中这一比例为59%（P = 0.04）。在有病毒尿的中心，血清转化与不戴手套之间的关联增强（P = 0.04）。仅照顾婴儿的工作人员比既照顾婴儿又照顾幼儿或仅照顾幼儿的工作人员发生血清转化的可能性略高。逻辑回归证实，出生于加拿大境外、家中有5岁以下儿童且家庭人口增多的工作人员血清阳性的可能性更大。如果工作人员在换尿布时不戴手套的中心工作、仅照顾婴儿而非幼儿和婴儿且年龄小于30岁，则更有可能发生血清转化，每个因素都独立对模型产生影响。
巨细胞病毒感染在多伦多日托中心的儿童和工作人员中很常见。
