BBC News Online: Health
16 September, 2000
Day care centres incubate and spread antibiotic-resistant
bacteria which cause infections of the respiratory
system, say researchers.
Israeli researchers tested toddlers attending day centres
to see if they were harbouring the Streptococcus pneumoniae
(strep) bacteria that cause respiratory infections.
They found that the high use of antibiotics among the
children had led to the rapid evolution of resistant strains
of the bacteria which were found in the youngsters noses
and throats.
Lead researcher Dr Ron Dagan, of Ben-Gurion University
in Beer-Sheva, Israel, said: "Day care centres act
as microenvironments that facilitate and promote selection,
spread and transmission of antibiotic-resistant respiratory
tract organisms in the community and should be seen as
major targets for intervention."
The two-year study involved eight day-care centres in
Beer-Sheva and 240 toddlers and 46 of their siblings.
Types of bacteria
The researchers found that similar strains of bacteria
were found within individual day care centres - but that
different centres harboured different strains.
This suggests that each day care centre creates its own
microenvironment.
However, the researchers detected the same resistant S.
pneumoniae strains in siblings of attendees, suggesting
that resistance could easily spread beyond the confines
of a centre.
Dr Dagan said day care centres are ideal environments
for the development of such resistance because they are
associated with a high rate of respiratory infections that
leads to a high rate of antibiotic use.
They also bring together infants and toddlers whose hygiene
standards are not yet developed.
Dr Alan Johnson, of the Public Health Laboratory Service's
antibiotic resistance monitoring and reference laboratory,
said the study confirmed data from previous research.
He cited a case of two children from the same day care
centre in Houston, US, who fell ill with the same infection.
One developed meningitis, the other a related blood stream
infection.
When doctors carried out throat swabs from 82 other children
at the centre, they found that ten were carrying the same
multi-drug resistant strain of bacteria found in the two
ill children.
Artificial conditions
Dr Johnson told BBC News Online: "The taking of antibiotics
tends to be relatively high in children because they are
more prone to conditions such as ear infections.
"The more that antibiotics are used the stronger
the selection pressure for resistant bacteria to persist.
"In addition, children tend to be crowded together
so infection can be transmitted easily from person to person.
"Creating such an artificial set of circumstances
favours the development of antibiotic-resistant bacteria."
Dr Johnson suggested that day care centres implemented
strict hygiene standards to try to reduce the risk that
infections would be transmitted.
He suggested that facilities should be made available
for children with runny noses to be able to wash their
hands regularly.
http://news.bbc.co.uk/1/hi/health/926673.stm
