2007, Number 5
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salud publica mex 2007; 49 (5)
Interpersonal relationships and group A streptococcus spread in a Mexican day-care center
Villaseñor-Sierra A, Quiñonez-Alvarado MG, Caballero-Hoyos JR
Language: English
References: 19
Page: 323-329
PDF size: 183.56 Kb.
ABSTRACT
Objective. To study the effect of different degrees of centrality on the carrying of identical group A streptococcus (GAS) clones in the nasopharynx of children from a Mexican public day-care center.
Material and Methods. Nasopharyngeal cultures were performed in children from rooms B (RB) (n = 35) and C (RC) (n = 37). The Restriction Fragment Length Polymorphism (RFLP) patterns were compared among GAS isolates. A social networks questionnaire was filled out for each child and 10 classmates. Structure coefficients were compared among children with and without GAS.
Results. Four GAS clones were identified; clone I in five children from RC; clone II in two from RC and one from RB; clone III in one from RB and one from RC; and clone IV in one from RC. Social network structure: Density of RB and RC = 0.40 (± 0.87) and 0.35 (± 0.80), respectively. In RB, the homophily pattern of interaction was different in carriers (0.00), non-carriers (0.47) and both (0.47) p = 0.35. In RC, the homophily pattern was also different in carriers (0.46), non-carriers (0.68) and mixed (0.19), p = .001. In 4/5 with clone I, the values of degree, closeness and betweenness were above the group mean. In 3/3 with clone II, the values of degree and betweenness were also above the mean. In contrast, in those with clone III and IV, the values of degree, closeness and betweenness were below the group mean.
Conclusions. The spread of specific GAS clones was associated with groups of children having a high proportion of ties and a high centrality level. This is evidence that spread of GAS strains among children attending day-care centers is not random but dependent on the degree of communication and physical contact between pairs.
REFERENCES
Stevens DL. Invasive group A streptococcus infections. Clin Infect Dis 1992;14:2-13.
Stevens DL. Invasive group A streptococcal infections: the past, present and future. Pediatr Infect Dis J 1994;13:561-566.
Muotiala A, Saxen H, Vuopio-Varkila J. Group A streptococcal outbreak of perianal infection in a day-care centre. Adv Exp Med Biol 1997;418:211-215.
Yagupsky P, Landau D, Beck A, Dagan R. Carriage of Streptococcus pyogenes among infants and toddlers attending day-care facilities in closed communities in southern Israel. Eur J Clin Microbiol Infect Dis 1995;14:54-58.
Falck G, Kjellander J. Outbreak of group A streptococcal infection in a day-care center. Pediatr Infect Dis J 1992;11(11):914-919.
Hsueh PR, Teng LJ, Lee PI, Yang PC, Huang LM, Chang SC, et al. Outbreak of scarlet fever at a hospital day-care centre: analysis of strain relatedness with phenotypic and genotypic characteristics. J Hosp Infect 1997;36:191-200.
Smith TD, Wilkinson V, Kaplan EL. Group A streptococcus-associated upper respiratory tract infections in a day-care center. Pediatrics 1989;83:380-384.
Engelgau MM, Woernle CH, Schwartz B, Vance NJ, Horan JM. Invasive group A streptococcus carriage in a child care centre after a fatal case. Arch Dis Child 1994;71:318-322.
al Qutob R, Na’was T, Mawajdeh S. The role of day-care givers in the identification and prevention of infections. Soc Sci Med 1991;33:859-862.
Weiss K, Laverdiere M, Lovgren M, Delorme J, Poirier L, Beliveau C. Group A Streptococcus carriage among close contacts of patients with invasive infections. Am J Epidemiol 1999;149:863-868.
Nguyen L, Levy D, Ferroni A, Gehanno P, Berche P. Molecular epidemiology of Streptococcus pyogenes in an area where acute pharyngotonsillitis is endemic. J Clin Microbiol 1997;35:2111-2114.
Social Network Analysis in the Social and Behavioral Sciences. En: Wasserman S, Faust K, eds. Social Network Analysis. Cambridge: Cambridge University Press, 1994:3-27.
Freeman, LC. Centrality in Social Networks: I. Conceptual Clarification. Social Networks 1979;1:215-239.
Fitzpatrick LK, Hardacker JA, Heirendt W, Agerton T, Streicher A, Melnyk H, et al. A preventable outbreak of tuberculosis investigated through an intricate social network. Clin Infect Dis 2001;33:1801-1806.
Edmunds WJ, O’Callaghan CJ, Nokes DJ. Who mixes with whom? A method to determine the contact patterns of adults that may lead to the spread of airborne infections. Proc Biol Sci 1997;264:949-957.
Centrality and Prestige. En: Wasserman S, Faust K, eds. Social Network Analysis. 1st. Cambridge: Cambridge University Press, 1994:169-219.
Gardiner D, Hartas J, Currie B, Mathews JD, Kemp DJ, Sriprakash KS. Vir typing: a long-PCR typing method for group A streptococci. PCR Methods Appl 1995;4:288-293.
Hartas J, Hibble M, Sriprakash KS. Simplification of a locus-specific DNA typing method (Vir typing) for Streptococcus pyogenes. J Clin Microbiol 1998;36:1428-1429.
Kaplan EL. The group A streptococcal upper respiratory tract carrier state: an enigma. J Pediatr 1980;97:337-345.