Limiting the spread of penicillin-resistant Streptococcus pneumoniae: experiences from the South Swedish Pneumococcal Intervention Project.

In an attempt to limit the spread of penicillin-resistant pneumococci (PRP), an intervention project was initiated in the Malmöhus County, southern Sweden in January 1995. The ongoing project combines traditional communicable disease control measures and actions aiming at reducing antibiotics consumption. All patients in the county with a nasopharyngeal culture positive for PRP with MIC of Penicillin G > or =0.5 mg/L are followed with nasopharyngeal cultures until PRP-negative. Nasopharyngeal cultures are obtained from family members and close contacts of the index cases. Preschool children carrying PRP are denied attendance at group day-care. From January 1995 to March 1997, 1,038 PRP-carriers (429 index cases and 609 contact cases) were identified. Children aged 1-6 years dominated (83%). Antibiotics sales decreased during the study period, and epidemiologic data indicate that the intervention may have limited the dissemination of PRP in the county, but further evaluation is needed.