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Prevalence of nasopharyngeal carriage of pneumococcus in preschool children attending day care in London
  1. Anita Roche (anita.roche{at}wpct.nhs.uk)
  1. South West London Health Protection Unit, United Kingdom
    1. Paul T Heath (pheath{at}sgul.ac.uk)
    1. St. George's, University of London, United Kingdom
      1. Mike Sharland (mike.sharland{at}stgeorges.nhs.uk)
      1. St George's Hospital NHS Trust, United Kingdom
        1. David Strachan (dstrachan{at}sgul.ac.uk)
        1. St. George's, University of London, United Kingdom
          1. Aodhan Breathnach
          1. St George's Hospital NHS Trust, United Kingdom
            1. John Haigh
            1. St George's Hospital NHS Trust, United Kingdom
              1. Yvonne Young
              1. South West London Health Protection Unit, United Kingdom

                Abstract

                Objective: To estimate the prevalence of nasopharyngeal (NP) carriage of pneumococcus (Streptococcus pneumoniae) and describe the antibiotic resistance patterns and serotypes in young children attending group day-care in London.

                Design & Subjects: Cross-sectional survey of attendees at a sample of registered child day-care centres (CDCCs) in a London borough.

                Setting: Urban setting with socially and culturally diverse population.

                Methods & Outcomes: 19 CDCCs (13% of total) participated between March and November 2003. A single NP swab was required from each child, and parents completed a questionnaire about their child’s health and attendance at day care. WHO methodology for pneumococcal carriage studies was followed.

                Results: 30% of parents consented. 234 swabs were collected from children aged 6 months to 5 years. 53% were boys and 81% were white. 120 children (51%) (95% CI 45% to 58%) carried pneumococci in their nasopharynx. None of the isolates were resistant to penicillin (upper CL 3%). 21 isolates were resistant to erythromycin (17.5%, 95%CIs 11%, 25.5%). 68 isolates (57%) were serotypes included in the 7-valent conjugate vaccine. Non-whites had a lower prevalence of carriage (27% vs 58%).

                Conclusion: The prevalence of pneumococcal NP carriage was high. The penicillin resistance rate is lower than in many other countries and may reflect a decrease in community antibiotic prescribing in the UK. Monitoring circulating serotypes is important in the context of recent changes to the vaccination policy. Further study is required to explore the association with ethnicity and risk factors for antibiotic resistance.

                • antibiotic resistance
                • child day care
                • pneumococcal carriage
                • streptococcus pneumoniae

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