title: Drug-resistant Streptococcus pneumoniae in day-care centres in Stockholm County.
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.
authors.affiliation: Department of Communicable Disease Control and Prevention, Karolinska Hospital, Stockholm, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Christenson
authors.forename: S P
authors.initials: SP
authors.lastname: Sylvan
authors.forename: B
authors.initials: B
authors.lastname: Noreen
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002353:Carrier State; D016009:Chi-Square Distribution; D002656:Child Day Care Centers; D002675:Child, Preschool; D016358:Contact Tracing; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D006801:Humans; D007223:Infant; D008826:Microbial Sensitivity Tests; D009305:Nasopharynx / Q000382:microbiology; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000382:microbiology* / Q000635:transmission; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification*; D013548:Sweden
chemical_list: D000900:Anti-Bacterial Agents