The prevalence of colonization with drug-resistant pneumococci among adult workers in children's daycare

Abstract

We conducted a study to determine if employment at a children's daycare facility increases an adult's risk of carrying Streptococcus pneumoniae in general and antibiotic-resistant S pneumoniae in particular. From January through March 2003, we obtained nasopharyngeal and oropharyngeal specimens from 63 adult workers at 6 daycare facilities and 65 similarly aged controls; all but 2 controls were nonclinical employees at our tertiary care center. Culture and sensitivity data were obtained from all specimens, and written questionnaires were used to gather information on each daycare worker, control, and daycare center. The vaccination records of children at 5 of the 6 daycare centers were reviewed. Odds ratios with 95% confidence intervals were calculated to compare the rates of colonization with S pneumoniae in the daycare workers and controls. Multinomial logistic regression analysis was used to compare different daycare centers and to identify risk factors for S pneumoniae carriage. Analysis of the results revealed that the prevalence of S pneumoniae colonization among daycare workers (3/63 [4.76%]) and controls (3/65 [4.62%]) was nearly identical. Whereas no S pneumoniae isolate from a daycare worker displayed multiple drug resistance, all 3 isolates from the controls did; however, this difference was not statistically significant. We conclude that employment at a children's day care facility in our community did not increase an adult's risk of carrying S pneumoniae. In fact, daycare workers may be even less likely to carry antibiotic-resistant S pneumoniae because of the widespread and successful use of the heptavalent pneumococcal vaccine in young children.