title: Independent risk factors for carriage of penicillin-non-susceptible Streptococcus pneumoniae.
abstract: Antibiotic treatment, day-care center (DCC) attendance and young age are associated with penicillin-non-susceptible Streptococcus pneumoniae (PNSSp) carriage. Yet, it is unclear whether each is an independent risk factor for the individual. This cross-sectional surveillance study was designed to answer this question. Nasopharyngeal cultures were obtained from 429 children (< 6 y) during a visit to the pediatrician's office. Two risk rates were calculated: the individual's absolute risk to carry PNSSp [simple odds ratio (ORS)] and the risk of an individual who is already a carrier [conditional odds ratio (ORC)]. Streptococcus pneumoniae was isolated from 52.7% of 401 children. PNSSp was detected in 37.1% of carriers. Independent risk factors were: young age [ORS 2.24, 95% confidence interval (95% CI) 1.2-4.2], DCC attendance (ORS 3.8, 95% CI 1.9-7.5), having young siblings (ORS 2.3, 95% CI 0.95-5.57) and each antibiotic treatment during the previous 3 months (ORS 1.5, 95% CI 1.25-1.85). The only significant risk factor among carriers was prior antibiotic treatment (ORC 2.24, 95% CI 1.64-3.05). Young children, who attended DCC and received 1 antibiotic course (9% of the population) had a risk 12.9 times higher than children without these features.
authors.affiliation: Infectious Disease Unit, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel. regevyoc@inter.net.il
authors.forename: Gili
authors.initials: G
authors.lastname: Regev-Yochay
authors.forename: Meir
authors.initials: M
authors.lastname: Raz
authors.forename: Bracha
authors.initials: B
authors.lastname: Shainberg
authors.forename: Ron
authors.initials: R
authors.lastname: Dagan
authors.forename: Miriam
authors.initials: M
authors.lastname: Varon
authors.forename: Marina
authors.initials: M
authors.lastname: Dushenat
authors.forename: Ethan
authors.initials: E
authors.lastname: Rubinstein
mesh_terms: D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002353:Carrier State; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D015999:Multivariate Analysis; D009305:Nasopharynx / Q000382:microbiology; D016017:Odds Ratio; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000453:epidemiology*; D011336:Probability; D012307:Risk Factors; D017678:Sex Distribution; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents