Day care centres breed 'superbugs'

Children together spread germs

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.

Day care centres act as microenvironments

Dr Ron Dagan, Ben-Gurion University

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.