Nasal carriership of Staphylococcus aureus, Streptococcus pyogenes and Streptococcus pneumoniae in children visiting daycare centres

Abstract number: P2202

Boesten R.C.H., Nys S., Dukers-Muijrers N.H.T.M., Jacobs P.H.A., Stobberingh E.E., Hoebe C.J.P.A.

Staphylococcus aureus (SA) and Streptococcus pyogenes (SPy) can cause significant morbidity in children (e.g. impetigo). Streptococcus pneumoniae (SPn) is the most common cause of bacterial meningitis in adults and children. In the Netherlands neonates are vaccinated for SPn since April 2006. In this study the (risk factors for) carriership of SA, SPy and SPn in children visiting daycare centres were determined.

Cross-sectional study between March and July 2007 in which nasal swabs and questionnaires (including socio-demographics, as well as some behavioral characteristics) were taken from 620 children (aged 0–4 years) in 48 randomly chosen daycare centres in the southern part of the Netherlands. Identification of SA, SPy and SPn was performed using standard biochemical tests. Susceptibility for fucidic acid was determined using the disc diffusion method. Logistic regression analyses were done to identify independent risk factors for carriership (p < 0.1).

A nasal carriership of 17.3% was shown for SA, 0.8% for SP and 37.8% for SPn. MRSA was not found in any tested sample. 5.7% of the SA positive samples were resistant and 23.5% were intermediate susceptible for fucidic acid, the standard treatment. Only 0.9% were resistant of mupirocine, the second choice treatment.

Preliminary analyses on 371 subjects revealed that independent predictors for presence of SA were young age (p = 0.09) and skin diseases (mostly eczema, p = 0.01), but this was only the case for children under the age of 2. Carriership of SPy and SPn were inversely related (p < 0.001). Two respondents who reported keeping pigs were both carrier of SA (p = 0.04). Respondents keeping farm-animals tend to be less often sensitive to fusidic acid (p = 0.09).

The absence of SA was the only predictor for carriership of SPn. Carriership of SPn is not different between children who received (at least one) SPn vaccination and non-vaccinated children.

Nasal carriership of SA in children is slightly lower than the carriership in the common population (20–55% in the Netherlands). A high percentage of carriers are diminished susceptible for the standard treatment of impetigo caused by SA. Further research on the carriership and transmission patterns of SA is currently being conducted.

We showed that SPn can be successfully obtained from nasal swabs.

Results further suggest that SPn vaccinated children are still part of the SPn transmission chain.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Location: Barcelona, Spain
Presentation type:
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