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Haemophilus influenzae type b colonization in children in a hospital-based day care center
N Akçakaya1, Y Camcioğlu, S Belbek
1Department of Pediatrics, Cerrahpasa Medical Faculty Day-Care Center, Cerrahpasa Medical Faculty, Istanbul University, Turkey.
Insights
Day care center attendance significantly increases Haemophilus influenzae type b (Hib) colonization in children. Parental employment in healthcare settings does not impact Hib carriage rates, with duration of day care being the key factor.
Area of Science:
- Microbiology
- Public Health
- Pediatrics
Background:
- Haemophilus influenzae type b (Hib) pharyngeal colonization is a concern in pediatric populations.
- Day care centers (DCCs) are known environments for pathogen transmission among young children.
- The impact of parental occupation on pediatric disease carriage requires further investigation.
Purpose of the Study:
- To evaluate the effect of day care center (DCC) attendance on Haemophilus influenzae type b (Hib) pharyngeal colonization.
- To determine if parental employment in health care settings influences Hib carriage rates in children attending DCCs.
- To assess the prevalence of Hib colonization in unvaccinated Turkish children.
Main Methods:
- Nasopharyngeal cultures were obtained from children attending hospital-based and community DCCs in Turkey.
- Children of health care workers and non-health care workers were compared.
- Cultures were taken at enrollment and after 3 and 6 months of DCC attendance.
Main Results:
- Hib carrier state increased from 4% at enrollment to 22% after 3 months in children attending CMF-DCC.
- After more than 6 months of attendance, Hib carrier rates reached 40.7% and 47.5% in CMF-DCC and Bahcelievler-DCC, respectively.
- No significant difference in Hib carriage rates was observed between children of health care workers and those from non-medical families.
Conclusions:
- Duration of day care center attendance is a significant factor influencing Haemophilus influenzae type b (Hib) carriage rates.
- Parental employment in health care facilities does not appear to affect Hib carriage prevalence in children attending DCCs.
- These findings highlight the importance of DCC attendance duration in the epidemiology of Hib colonization in unvaccinated populations.
Abstract:
We sought to assess the effect of day care center (DCC) attendance and parental health care work environment on the prevalence of Haemophilus influenzae type b (Hib) pharyngeal colonization in children in Turkey. Children of health care workers were evaluated by nasopharyngeal culture specimens obtained prior to enrollment at a hospital-based DCC at Cerrahpasa Medical Faculty (CMF-DCC) and then again after 3 months of attendance. A larger cohort from this same DCC was evaluated after 6 months of attendance and compared to a group of children of non-health care workers enrolled in Bahcelievler-DCC. As is standard of care in Turkey, none of these children had received the Hib vaccine. Fifty children of health care workers were evaluated prior to their enrollment and then again after 3 months at CMF-DCC. The incidence of Hib carrier state at enrollment was 4% and increased to 22% after 3 months at the DCC. To assess the affect of parental health care employment on Hib carriage rates, 103 children from CMF-DCC and 40 children of non-medical families at Bahcelievler-DCC were evaluated. Hib carrier state was identified in 40.7 and 47.5% after more than 6 months of attendance at CMF-DCC and Bahcelievler-DCC, respectively. No significant difference was observed between carriage rates of children coming from medical and non-medical families and the average carriage rate was 42.6% when duration of day-care attendance exceeded 6 months. Our results demonstrate that Hib carriage rates are affected by the duration of DCC attendance. Parents' employment in a health care facility does not affect carriage rates.