Journal Article

Carriage of Multidrug-Resistant <i>Streptococcus pneumoniae</i> and Impact of Chemoprophylaxis During an Outbreak of Meningitis at a Day Care Center

Allen S. Craig, Paul C. Erwin, William Schaffner, John A. Elliott, William L. Moore, Xilla T. Ussery, Lori Patterson, Anthony D. Dake, Stuart G. Hannah and Jay C. Butler

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 29, issue 5, pages 1257-1264
Published in print November 1999 | ISSN: 1058-4838
Published online November 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313451
Carriage of Multidrug-Resistant Streptococcus pneumoniae and Impact of Chemoprophylaxis During an Outbreak of Meningitis at a Day Care Center

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Three cases of meningitis due to multidrug-resistant serotype 14 Streptococcus pneumoniae occurred at a day care center (DCC) over 5 days. Cultures of nasopharyngeal samples were done at the index DCC, 2 comparison DCCs, and a pediatrics practice. Isolates were serotyped and subtyped by pulsed-field gel electrophoresis (PFGE) with SmaI. Pneumococcal carriage rates ranged from 44%–65% atthe 3 DCCs and 29% in the pediatrics practice. Carriage of multidrug-resistant serotype 14 S. pneumoniae was noted in 13%–19% of children at the 3 DCCs. An outbreak strain was identified by PFGE at the index DCC and 1 other DCC; a closely related strain was found in the third DCC. Carriage of the outbreak strain was associated with being age 0–24 months, antibiotic use, upper respiratory tract infections, and otitis media. DCC contacts of the ill children were offered chemoprophylaxis with rifampin and clindamycin, which produced a profound but transient decrease in carriage. No additional cases occurred.

Journal Article.  5442 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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