Presence of Pathogenic Bacteria and Viruses in the Daycare Environment

By Ibfelt, Tobias; Engelund, Eva Hoy et al. | Journal of Environmental Health, October 2015 | Go to article overview

Presence of Pathogenic Bacteria and Viruses in the Daycare Environment


Ibfelt, Tobias, Engelund, Eva Hoy, Permin, Anders, Madsen, Jonas Stenlokke, Schultz, Anna Charlotte, Andersen, Leif Percival, Journal of Environmental Health


Introduction

Children, especially young children aged 0-3 years, have a high frequency of infectious disease episodes (Denny, Collier, & Henderson, 1986). Daycare centers (DCCs) worldwide are ideal places for infections to spread because of the density of small children and their constant interaction. Moreover, the number of children attending DCCs is increasing. In Denmark, the vast majority of small children are cared for in center-based institutions, and in the U.S., center-based care is now the dominant form of care for young children (ChildStats.gov, 2013). Thus, it is not surprising that young children attending DCCs have more sick days than children cared for elsewhere (Bartlett et al., 1985; Fleming, Cochi, Hightower, & Broome, 1987; Uldall, 1990). This is in part due to the spread of infectious microorganisms from child to child. Other pathways of pathogen transmission may play a role, but this has not been well investigated.

Every day, the daycare environment is exposed to thousands of different microorganisms from the children, staff, and parents, but whether these fomites play a role in disease transmission is not well known. The focus in research within this field has previously been on presence of nonpathogenic bacteria or low-pathogenic bacteria in the DCC environment (Cosby et al., 2008; Laborde, Weigle, Weber, & Kotch, 1993; Staskel, Briley, Field, & Barth, 2007). Studies using culture samples have found that 10%-60% of the samples are positive for coliform bacteria depending on location. Studies using molecular methods such as quantitative polymerase chain reaction (qPCR) have determined the diversity of bacteria in DCCs and found that the main bacteria flora in the DCC environment consisted of coagulase-negative staphylococci (CoNS), Bacillus spp., and Pseudomonas-like bacteria, all of which rarely cause disease in healthy humans (Lee, Tin, & Kelley, 2007).

The majority of infections in DCCs are respiratory infections, which are mainly caused by viruses such as rhinovirus, bocavirus, adenovirus, and respiratory syncytial virus (RSV) (Fairchok et al., 2010; Martin, Fairchok, Stednick, Kuypers, & Englund, 2013; Pitkaranta et al., 2006). The presence and amount of these viruses in the DCC environment is unclear (Denny et al., 1986). A few studies have looked at influenza virus and rotavirus in the environment but these viruses are only two of the viral pathogens (Boone & Gerba, 2005; Butz, Fosarelli, Dick, Cusack, & Yolken, 1993; Keswick, Pickering, DuPont, & Woodward, 1983). Viruses causing a common cold, which is by far the most prevalent disease among young children, have not yet been the subject of thorough investigations in the DCC environment.

The aim of our study was to determine the presence and quantity of bacteria and viruses in the DCC environment and to locate the fomites with the highest prevalence of pathogens.

Materials and Methods

Recruitment of Institutions

Twenty-three institutions were recruited in the fall of 2011. They were randomly selected among all the public daycare centers in the municipalities of Copenhagen and Nyborg because these two municipalities had agreed to be a part of the project. Recruited institutions were all "integrated institutions" with both nursery and kindergarten divisions. The number of divisions in each institution ranged from two to seven and the number of children per institution ranged from 24 to 149. The total number of children was 1,820.

Virus Sampling and Processing

Gastrointestinal viruses were sampled from six locations and respiratory viruses were sampled from three (Table 1). A location of 10 x 10 cm was sampled using a 15 x 25 mm polyester foam swab. The swab was immersed in sterile, RNase-free water before sampling. After sampling, the swab was put into a 15-mL sterile plastic container with 5 mL Nuclisens lysis buffer. Upon arrival to the lab, the tubes were placed on a shaking table for 20 minutes and the lysis buffer was transferred to a 3. …

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