Spread of Streptococcus pneumoniae and antibiotic-resistant S. pneumoniae from day-care center attendees to their younger siblings Academic Article uri icon

abstract

  • A prospective study was conducted to determine the association between pneumococcal carriage among 36 infants and young toddlers cared for at home and carriage among their older siblings who attended 8 day-care centers (DCCs); 71 pneumococcal strains acquired by the younger siblings were compared with those present in the DCCs for 6 months. In 76% of cases, 1 strain identical by serotype and antibiogram was isolated in the older siblings’ DCC versus 32%–63% in all other DCCs ( ). When phenotypically identical strains were P ! .001 compared by pulsed-field gel electrophoresis, the similarity between strains from older siblings’ DCCs and the younger siblings’ isolates was striking. This was not found when isolates from other DCCs were compared. Vaccinating DCC attendees with a 7-valent pneumococcal conjugate vaccine may play a key role in controlling the spread of antibiotic-resistant pneumococci, because the most resistant serotypes are included in the vaccine. Children attending day-care centers (DCCs) are at higher risk of carriage of Streptococcus pneumoniae in general, and antibiotic-resistant S. pneumoniae in particular, than are children who are cared for at home [1–10]. Extensive carriage of the organisms in DCC attendees has been well documented [2, 3, 11–14]. Young children who have older siblings attending DCCs tend to have more respiratory diseases than do those who do not have older siblings in DCCs [15, 16]. They also have a higher carriage rate of antibiotic-resistant S. pneumoniae [2]. However, the role of DCCs in the spread of S. pneumoniae to the family, particularly to younger siblings of DCC attendees, has not been studied systematically. The present prospective study was conducted to determine the role of DCCs in the spread of S. pneumoniae to the community in general, and antibiotic-resistant S. pneumoniae in particular, by examining the association between carriage among infants and young toddlers being cared for at home and carriage in the DCCs attended by their older siblings. Subjects, Materials, and Methods

publication date

  • January 1, 2002