The impact of active intervention on the spread of penicillin-resistant streptococcus pneumoniae in Swedish day-care centres

Research output: Contribution to journalArticle

Abstract

Policies for handling cases of penicillin-non-susceptible Streptococcus pneumoniae (PNSP) in day-care groups vary between different counties in Sweden. The aim of this study was to evaluate the epidemiological effect of excluding PNSP-carriers from children's day-care centres (DCC). We followed the incidence in 14 DCC groups with ongoing PNSP-spread, by repeated group screens until no further cases could be identified. All identified carriers were excluded from DCC attendance in study area A (Skane region) while they remained in the group in study area B (Goteborg and Orebro), according to local policies. The intervention effect was evaluated by comparing the number of additional cases after the baseline screen (start of the intervention period) between the 2 study areas. All PNSP-isolates were characterized by resistance pattern, serotype and pulse-field gel electrophoresis. The relative risk for children in DCCs without active intervention was 6.4 (95% CI: 2.0-20.7). Each prevented case in area A can be estimated to have demanded the exclusion of 2 other children from day care for approximately 4 weeks each. The total cost-benefit outcome of this action has to be seen in the light of the local situation with regard to the population prevalence and the distribution of other risk factors.

Details

Authors
  • L Hogberg
  • BH Normark
  • H Ringberg
  • K Stenqvist
  • H Fredlund
  • P Geli
  • K Grabowska
  • E Melander
  • Martin Laurell
  • C Ahren
  • E Tornqvist
  • R Falt
  • D Hoglund
  • G Mollerberg
  • K Ekdahl
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Infectious Medicine
Original languageEnglish
Pages (from-to)629-635
JournalScandinavian Journal of Infectious Diseases
Volume36
Issue number9
Publication statusPublished - 2004
Publication categoryResearch
Peer-reviewedYes