Risk factors for nasopharyngeal carriage of Streptococcus pneumoniae and effects of a hygiene intervention: repeated cross-sectional cohort study at day care centres.

• Published in: Scandinavian Journal of Infectious Diseases
• Main Authors: Gudnason, Thorolfur, Hrafnkelsson, Birgir, Laxdal, Brynja, Kristinsson, Karl G
• Other Authors: Landspitali Univ Hosp, Directorate Hlth, Chief Epidemiologists Offi, Reykjavik, Iceland, Landspitali Univ Hosp, Dept Paediat, Reykjavik, Iceland, Univ Iceland, Fac Phys Sci, Dept Math, IS-101 Reykjavik, Iceland, Landspitali Univ Hosp, Dept Clin Microbiol, Reykjavik, Iceland, Univ Iceland, Fac Med, IS-101 Reykjavik, Iceland
• Format: Article in Journal/Newspaper
• Language: English
• Published: Informa Healthcare 2014
• Subjects: Bakteríusjúkdómar; Leikskólabörn; Hreinlæti; Pneumococcal Infections/etiology; Carrier State/epidemiology*; Child; Preschool; Nasopharynx/microbiology*; Pneumococcal Infections/epidemiology*; Pneumococcal Infections/prevention & control; Streptococcus pneumoniae/drug effects*; Child Day Care Centers; Hand Hygiene/methods; Iceland/epidemiology; Respiratory Tract Infections/epidemiology*; Respiratory Tract Infections/prevention & control; Risk Factors; Anti-Bacterial Agents/pharmacology*; Anti-Bacterial Agents/therapeutic use; Carrier State/prevention & control*; Cross-Sectional Studies; Day Care; Female; Humans; Hygiene; Male; Microbial Sensitivity Tests; Penicillin Resistance; Penicillins/pharmacology*; Penicillins/therapeutic use; Streptococcus pneumoniae/isolation & purification; Iceland
• Online Access: http://hdl.handle.net/2336/326002; https://doi.org/10.3109/00365548.2014.901553

To access publisher's full text version of this article click on the hyperlink at the bottom of the page Day care attendance and antibiotic consumption are major risk factors for carriage of antibiotic-susceptible and non-susceptible pneumococci. We describe the nasopharyngeal carriage of antibiotic-susceptible and non-susceptible pneumococci among children at day care centres (DCCs), analyse the association of potential risk factors with carriage, and examine the effects of a hygiene intervention on carriage. Thirty DCCs in 2 communities were included in a cohort intervention trial. Nasopharyngeal cultures and information on the children were obtained every 6 months. The study lasted 2.5 y and the hygiene intervention was introduced at half of the DCCs during the last 1.5 y of the study. The results were analysed using a mixed effects logistic regression model. A total of 5663 cultures were obtained from 2399 children, of which 55.6% grew pneumococci. Of the pneumococci, 27.9% were penicillin-non-susceptible (PNSP). The hygiene intervention was associated with a decreased risk of pneumococcal carriage, but this did not reach statistical significance for PNSP carriage. Pneumococcal and PNSP carriage was negatively associated with age, varied significantly between DCCs, and was positively associated with the number of preceding colds. Individual antibiotic use (mainly penicillin/amoxicillin) at the time of sampling and/or during the preceding month was associated with a decreased risk of pneumococcal and PNSP carriage. Individual use of cephalosporins was associated with an increased risk of carriage of penicillin and TMP-SMX-non-susceptible pneumococci. The hygiene intervention at the DCCs reduced the risk of pneumococcal carriage and the individual use of antibiotics was found to affect carriage in a complex manner. EC/QLK2-CT-2000-01020 (EURIS) Icelandic Centre for Research (RANNIS) 00-067-FS