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Prevalence of nasopharyngeal carriage of pneumococcus in preschool children attending day care in London
  1. Anita Roche1,
  2. Paul T Heath2,
  3. Mike Sharland3,
  4. David Strachan2,
  5. Aodhan Breathnach3,
  6. John Haigh3,
  7. Yvonne Young4
  1. 1
    South West London Health Protection Unit, Springfield University Hospital, London, UK
  2. 2
    St George’s, University of London, London, UK
  3. 3
    St George’s Hospital NHS Trust, London, UK
  4. 4
    South West London Health Protection Unit, London, UK
  1. Dr Anita Roche, South West London Health Protection Unit, Springfield University Hospital, 61 Glenburnie Road, London SW17 7DB, UK; anita.roche{at}


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

Setting: Urban setting with a socially and culturally diverse population.

Methods and 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% CI 11% to 25.5%). 68 isolates (57%) were serotypes included in the 7-valent conjugate vaccine. Non-white children 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.

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  • Approval of the Wandsworth Local Research Ethics Committee was sought and obtained in November 2002.

  • Financial support for this study was provided by Wyeth Vaccines.

  • Competing interests: St Georges, University of London has received funding from vaccine manufacturers including Wyeth on behalf of PT Heath for undertaking research. PTH has received funding from Wyeth for attending meetings. No other competing interests declared.

  • Abbreviations:
    child day care centre
    invasive pneumococcal disease
    skim milk-tryptone-glucose-glycerol

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