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Carriage of penicillin-resistant Streptococcus pneumoniae by children in day-care centers during an intervention program in Malmo, Sweden

Nilsson Wimar, Percy LU and Laurell, Martin LU (2001) In Pediatric Infectious Disease Journal 20(12). p.1144-1149
Abstract
BACKGROUND: An increasing incidence of penicillin-resistant Streptococcus pneumoniae (PRP) was detected in Malmo in 1994. OBJECTIVE: To evaluate clonality and factors facilitating the spread of PRP among children in day-care centers (DCCs). METHODS: We used phenotypic and DNA-fingerprinting methods in conjunction with epidemiologic data from the South Swedish Pneumococcal Intervention Project's investigation of 63 DCCs during a 3-year period (1995 to 1997) in the Malmo region. RESULTS: A questionnaire about building and hygiene standards disclosed no statistically significant risk factor for carriage of pneumococci. However, age younger than the mean age at the DCC or in the child group was positively associated with carriage. Contrary to... (More)
BACKGROUND: An increasing incidence of penicillin-resistant Streptococcus pneumoniae (PRP) was detected in Malmo in 1994. OBJECTIVE: To evaluate clonality and factors facilitating the spread of PRP among children in day-care centers (DCCs). METHODS: We used phenotypic and DNA-fingerprinting methods in conjunction with epidemiologic data from the South Swedish Pneumococcal Intervention Project's investigation of 63 DCCs during a 3-year period (1995 to 1997) in the Malmo region. RESULTS: A questionnaire about building and hygiene standards disclosed no statistically significant risk factor for carriage of pneumococci. However, age younger than the mean age at the DCC or in the child group was positively associated with carriage. Contrary to expectations no association with the number of children, either at the DCC or in the individual groups, was found. Of 2912 investigated children 1224 (42%) were carriers of S. pneumoniae, and 373 (12.8%) were PRP carriers (MIC > or = 0.1 microg/ml). Among isolates with MIC > or = 0.5 microg/ml 9 serogroups and 30 genetic types were found. Two clones in serogroups 9 (33%) and 19 (24%) were dominant in most municipality districts, and dominance was sustained during the whole study period. The previously internationally recognized serotype 9V clone seemed to be very stable, with a single DNA type and resistance pattern during the study period. In contrast the serogroup 19 isolates and other serogroups had diverse DNA types and resistance patterns, supporting the hypothesis that DCCs have a unique microenvironment facilitating the recombination of penicillin-binding protein genes among streptococci. In five DCCs we found PRP isolates with two different serogroups but an identical genetic type, indicating that serotype shift may be a common phenomenon in DCCs. CONCLUSION: Multivariate logistic regression of risk factors disclosed that young age of the children in the child groups was a significant risk factor for carriage of S. pneumoniae. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Penicillin resistance, Streptococcus pneumoniae, day-care centers, arbitrarily primed PCR, BOX-A PCR.
in
Pediatric Infectious Disease Journal
volume
20
issue
12
pages
1144 - 1149
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:11740321
  • scopus:0035665849
ISSN
1532-0987
language
English
LU publication?
yes
id
217fbc60-8078-4c2a-8fd9-7bb134f38cef (old id 1122929)
date added to LUP
2008-07-08 11:02:41
date last changed
2018-05-29 11:01:44
@article{217fbc60-8078-4c2a-8fd9-7bb134f38cef,
  abstract     = {BACKGROUND: An increasing incidence of penicillin-resistant Streptococcus pneumoniae (PRP) was detected in Malmo in 1994. OBJECTIVE: To evaluate clonality and factors facilitating the spread of PRP among children in day-care centers (DCCs). METHODS: We used phenotypic and DNA-fingerprinting methods in conjunction with epidemiologic data from the South Swedish Pneumococcal Intervention Project's investigation of 63 DCCs during a 3-year period (1995 to 1997) in the Malmo region. RESULTS: A questionnaire about building and hygiene standards disclosed no statistically significant risk factor for carriage of pneumococci. However, age younger than the mean age at the DCC or in the child group was positively associated with carriage. Contrary to expectations no association with the number of children, either at the DCC or in the individual groups, was found. Of 2912 investigated children 1224 (42%) were carriers of S. pneumoniae, and 373 (12.8%) were PRP carriers (MIC > or = 0.1 microg/ml). Among isolates with MIC > or = 0.5 microg/ml 9 serogroups and 30 genetic types were found. Two clones in serogroups 9 (33%) and 19 (24%) were dominant in most municipality districts, and dominance was sustained during the whole study period. The previously internationally recognized serotype 9V clone seemed to be very stable, with a single DNA type and resistance pattern during the study period. In contrast the serogroup 19 isolates and other serogroups had diverse DNA types and resistance patterns, supporting the hypothesis that DCCs have a unique microenvironment facilitating the recombination of penicillin-binding protein genes among streptococci. In five DCCs we found PRP isolates with two different serogroups but an identical genetic type, indicating that serotype shift may be a common phenomenon in DCCs. CONCLUSION: Multivariate logistic regression of risk factors disclosed that young age of the children in the child groups was a significant risk factor for carriage of S. pneumoniae.},
  author       = {Nilsson Wimar, Percy and Laurell, Martin},
  issn         = {1532-0987},
  keyword      = {Penicillin resistance,Streptococcus pneumoniae,day-care centers,arbitrarily primed PCR,BOX-A PCR.},
  language     = {eng},
  number       = {12},
  pages        = {1144--1149},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Pediatric Infectious Disease Journal},
  title        = {Carriage of penicillin-resistant Streptococcus pneumoniae by children in day-care centers during an intervention program in Malmo, Sweden},
  volume       = {20},
  year         = {2001},
}