Related Experiment Videos
Drug-resistant Streptococcus pneumoniae in day-care centres in Stockholm County
B Christenson1, S P Sylvan, B Noreen
1Department of Communicable Disease Control and Prevention, Karolinska Hospital, Stockholm, Sweden.
Insights
Drug-resistant Streptococcus pneumoniae (DRSP) infections in preschoolers are a concern. Day-care settings can facilitate DRSP transmission, with index cases likely leading to further infections within the same group.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Drug-resistant Streptococcus pneumoniae (DRSP) poses a significant public health threat, particularly in vulnerable populations like preschool children.
- Antibiotic resistance in S. pneumoniae complicates treatment and increases the risk of disease transmission in community settings.
Purpose of the Study:
- To investigate the prevalence and transmission patterns of drug-resistant Streptococcus pneumoniae (DRSP) among preschool children attending day-care centers.
- To identify the role of day-care centers in the spread of DRSP strains within a preschool population.
Main Methods:
- A retrospective study identified 40 preschool children with DRSP between January 1994 and July 1995.
- Contact tracing and nasopharyngeal swabs were used to screen children and day-care personnel in affected centers.
- Minimum inhibitory concentration (MIC) testing determined penicillin sensitivity and resistance to other antibiotics.
Main Results:
- Of 40 DRSP cases, 25 were symptomatic index cases and 15 were asymptomatic carriers identified through contact tracing.
- In 11 day-care centers, 13 additional asymptomatic carriers were identified among 424 children screened.
- The same DRSP serotype was found in most index cases and identified carriers; no day-care personnel carried the strain.
Conclusions:
- Day-care centers are significant environments for DRSP transmission among young children.
- The presence of a DRSP-infected child in a day-care setting strongly suggests the likelihood of additional DRSP cases within the same group.
- Targeted screening in day-care settings is crucial for controlling DRSP outbreaks.
Abstract:
Between January 1994 and July 1995, 40 pre-school children were found to have drug-resistant Streptococcus pneumoniae(DRSP), i.e. reduced sensitivity to penicillin (minimum inhibitory concentration, MIC, > or =0.1) and resistance to at least two other antibiotic drugs. Twenty-five of the children were index cases with symptoms of respiratory disease, and 15 children were carriers discovered in contact-tracing in connection with an index case. Children attending the same group in the day-care centre as an index child were routinely screened. Thirteen of the index children were attending day-care centres. In 11 of these day-care centres, contact-tracing and nasopharyngeal swabs from 424 children and 128 day-care personnel identified an additional 13 asymptomatic children who were carriers of DRSP. In all but one case, the same serotype as the index case was discovered. No day-care personnel were carriers of the DRSP strain. Sixteen (64%) of the 25 children with symptoms caused by DRSP were 1 year old or younger, whereas eight (61%) of the 13 children who were carriers of DRSP were 3-4 years old. In conclusion, when a child attending a day-care centre is discovered to have respiratory disease caused by DRSP, there is a great probability that additional children will be identified in the group with the same DRSP strain.