Prevalence of penicillin-non-susceptible Streptococcus pneumoniae in children in day-care centres subjected to an intervention to prevent dispersion

Abstract

Background: The aim of this study was to evaluate the day-care interventions implemented in southern Sweden to restrict the dispersion of penicillin-non-susceptible pneumococci with a minimum inhibitory concentration of penicillin G of at least 0.5 mg/l (PNSP_0.5). Methods: A retrospective epidemiological study was performed and data from 109 day-care centre interventions from 2000 to 2010 were analysed, including screening results from 7157 individuals. Results: It was found that 42% of the children were carriers of pneumococci and 5% of the screened children were PNSP_0.5 carriers. Very few personnel were PNSP_0.5 carriers and they were carriers for only a short time. Significantly more contact cases with the same serogroup as the index case were found in the first screening and in the same department as the index case, but a substantial number of contact cases were found in adjacent departments. Conclusions: Screening of personnel is not worth the effort. Based on our results, procedures to restrict dispersion of PNSP_0.5 in day-care centres could be improved. To find the majority of contact cases with PNSP_0.5 an early screening including adjacent departments seems to be the best approach.

Keywords::

• Communicable disease control intervention
• day-care centre
• penicillin non-susceptible pneumococci
• pneumococcal carriage
• Streptococcus pneumoniae

Acknowledgements

We thank Rosmarie Fält at the Regional Department of Communicable Disease Control in Skåne County for support with finding and interpreting the data from paper files, and Fredrik Nilsson at the Region Skåne Competence Center for support with the statistical analysis.

Declaration of interest: Jonas Ahl is a member of Pfizer's Swedish pneumococcal advisory board. This work has been supported by Skåne County Council's Research and Development Foundation.