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Environmental contamination in child day-care centers
1Department of Pediatrics, University of Texas Medical School, Houston 77030.
Insights
Fecal coliform contamination is common in day-care centers, especially on toys and hands. Using overclothes significantly reduced contamination, and diarrhea outbreaks were linked to higher hand contamination levels.
Area of Science:
- Microbiology
- Public Health
- Pediatrics
Background:
- Diarrhea outbreaks in day-care centers are frequently caused by enteropathogens spread via the fecal-oral route.
- Contaminated hands and environmental objects are primary transmission vectors in these settings.
Purpose of the Study:
- To investigate the prevalence of fecal coliform contamination in day-care environments.
- To identify factors influencing contamination levels and their association with diarrhea.
Main Methods:
- A prospective study was conducted over 13 weeks in six day-care centers, involving 121 children under two years old.
- Cultures were taken from inanimate objects, toy balls, and hands multiple times weekly.
- Contamination levels were compared between infant and toddler rooms, and the impact of wearing overclothes was assessed.
Main Results:
- Fecal coliform contamination was prevalent on objects, toy balls, and children's hands, with higher rates in toddler rooms.
- The use of overclothes over diapers significantly decreased contamination on toy balls, objects, and hands.
- Diarrhea occurrence was strongly associated with increased hand contamination.
Conclusions:
- Fecal coliform contamination is widespread in day-care centers, with toy balls acting as indicators.
- Implementing the use of overclothes is an effective strategy to reduce fecal coliform contamination.
- Controlling fecal contamination is crucial for preventing diarrhea outbreaks in young children.
Abstract:
Enteropathogens associated with outbreaks of diarrhea in day-care centers are spread by the fecal-oral route through contaminated hands or environmental objects. This prospective study was undertaken to determine the prevalence of fecal coliform contamination in day care. Ten rooms in six centers housing 121 children less than 2 years of age were studied for 13 weeks (February to May 1988). Inanimate objects (n = 1,275), toy balls (n = 724), and hands (n = 954) were cultured 1-3 times per week. Fecal coliform contamination was common and was greater (p less than 0.05) for objects, toy balls, and hands of children in toddler compared with infant rooms. In five rooms in which clothes were worn over diapers, there was a significantly lower prevalence of fecal coliform contamination of toy balls (p less than 0.005), inanimate objects (p less than 0.05), and hands (p less than 0.001) when compared with rooms in which overclothes were not worn. Occurrence of diarrhea was significantly associated with increased contamination of hands (p = 0.001). Stool and environmental isolates from individual rooms had the same plasmid patterns, which were unique to each center. In summary, fecal coliform contamination of environmental objects and hands of children and caregivers in day-care centers is common; toy balls can serve as sentinels of contamination; fecal coliform contamination can be significantly decreased by use of overclothes; and Escherichia coli strains from stool showed the same plasmid patterns.