No Long-Term Risk for Increased Spread of PNSP in Day-Care Centres by Permitting Carriers to Remain in the Day-Care Centre Group

B. Christenson1, *, B. Henriques Normark2, B. Ardung1, K. Sjöström2, G. Eriksson1, P. Hartvig3, S.P.E. Sylvan1, *
1 Department of Communicable Disease Control and Prevention, Uppsala County Council, Uppsala, Sweden
2 Swedish Institute for Infectious Disease Control, Solna, Sweden
3 Department of Hospital pharmacy, Akademiska Hospital, University of Uppsala, Sweden

© 2008 Christenson et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Correspondence: * Address correspondence to this author at the Department of Communicable Disease Control and Prevention, Uppsala County Council, Dag Hammarskjolds vag 17, SE-751 85 Uppsala, Sweden.Email:


In a 6-year prospective epidemiological intervention study the spread of pneumococci non-susceptible to penicillin (PNSP) was studied among children attending day-care centres (DCCs). A primary aim was to investigate whether there was a risk for spread of PNSP by permitting children carrying PNSP strains to remain in the DCC. Carriers were followed until they presented negative cultures. The PNSP strains were characterised by serotyping, antibiotic susceptibility testing and clonality. Thirteen children with PNSP, initiated sampling of 321 children, 66 DCC personnel and 149 family members. Twenty-three (7 %) asymptomatic carriers were identified but none among the personnel. The most spread serotype was 6B (47%), followed by 19F (17%) and 9V (14%). The PNSP isolates were resistant to three antibiotics or more (69%). The spreading capability and duration of carriage differed between PNSP clones but no long-term risk for increased spread of PNSP in DCCs by carriers was found.