目的 分析青海省海东市6~10岁学龄儿童肺炎链球菌携带的聚集性及其影响因素，为预防和控制肺炎链球菌在学龄儿童间的传播提供科学依据。 方法 采用多阶段分层整群抽样和简单随机抽样的方法，抽取青海省海东市7所幼儿园和5所小学的834名6~10岁健康儿童，对所有儿童进行口拭子、鼻拭子采样并分离鉴定肺炎链球菌，对其家长进行问卷调查，采用卡方检验和随机效应logistic回归模型分析数据。 结果 儿童肺炎链球菌携带率为21.6%（180/834）。聚集性分析结果显示，肺炎链球菌携带在学校水平的随机效应具有统计学意义（Z=2.965，P=0.003，ICC=14.189%）。影响因素分析表明，8~10岁儿童肺炎链球菌携带率低于6~7岁儿童（OR=0.467，95%CI：0.232~0.938，P=0.032）；同住人口数3的儿童肺炎链球菌携带风险高于同住人口数≤3的儿童（OR=1.541，95%CI：1.016~2.339，P=0.042）。 结论 青海省海东市6~10岁学龄儿童肺炎链球菌携带存在学校聚集性；年龄、同住人口数是儿童肺炎链球菌携带的重要影响因素。

Objective To study the clustering of Streptococcus pneumoniae carriage among school children aged 6-10 years in Haidong City of Qinghai Province, and its influencing factors, providing scientific evidence for preventing and controlling the transmission of Streptococcus pneumoniae in this population. Methods Multistage stratified cluster sampling and simple random sampling were used to select 834 healthy children aged 6-10 years from seven kindergartens and five primary schools in Haidong City of Qinghai Province. Oral and nasal swabs were collected for isolation and identification of Streptococcus pneumoniae. Parents completed questionnaire surveys. Data analysis was performed using chi-square tests and random-effects logistic regression models. Results The carriage rate of Streptococcus pneumoniae was 21.6% (180/834). Cluster analysis showed statistically significant random effects at the school level (Z=2.965, P=0.003; ICC=14.189%). Children aged 8-10 years had a lower carriage rate than those aged 6-7 years (OR=0.467, 95%CI: 0.232-0.938, P=0.032). Children living in households with more than three cohabiting individuals had a higher risk of carriage compared to those with three or fewer (OR=1.541, 95%CI: 1.016-2.339, P=0.042). Conclusions Streptococcus pneumoniae carriage among school children aged 6-10 years in Haidong City of Qinghai Province exhibits school-level clustering. Age and number of cohabiting individuals are significant influencing factors for carriage.