Is the new approach to providing healthcare to children a safety threat?

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Bacteraemia in children in Iceland 1994-2005

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: Positive blood cultures from children suggest serious bloodstream infections. Quick medical response with targeted therapy is important, taking the child's age and medical history into account. Antibiotic therapy and vaccination programs must be based on accurate knowledge of the prevalence and antibiotic susceptibility of the bacteria. The aim of this study was to investigate epidemiological parameters associated with positive blood cultures in children in Iceland from September 20th 1994 to March 16th 2005. Materials and methods: All positive bacterial blood cultures from children 0-18 years of age identified at the Department of Clinical Microbiology of the Landspitali University Hospital during the study period. Age and sex of the children, bacterial aetiology, date of collection and results of antimicrobial susceptibility tests were registered. The children were divided into four age groups: neonates (Inngangur: Blóðsýkingar barna af völdum baktería geta verið alvarlegar. Skjót greining og viðeigandi meðferð geta skipt sköpum. Mikilvægt er að vita hvaða bakteríur eru algengastar hjá börnum á mismunandi aldri auk þess að þekkja sýklalyfjanæmi þeirra svo unnt sé að beita markvissri meðferð eða forvörnum. Markmið: Að draga fram helstu þætti í faraldsfræði blóðsýkinga barna á Íslandi á tímabilinu 20. september 1994-16. mars 2005. Efniviður og aðferðir: Allar jákvæðar niðurstöður blóðræktana hjá börnum 0-18 ára skráðar á Sýklafræðideild Landspítalans á rannsóknartímabilinu voru skoðaðar. Skráður var aldur og kyn sjúklings, tegund bakteríu sem ræktaðist, dagsetning sýnatöku og niðurstöður næmisprófa. Börnin voru flokkuð í fjóra aldurshópa; nýburar (<=30 daga), ungbörn (30 daga-1 árs), börn á leikskólaaldri (1-6 ára) og börn á skólaaldri (6-18 ára). Niðurstöður blóðræktana voru flokkaðar sem mengun, líkleg mengun, líkleg sýking eða sýking. Niðurstöður: Alls ræktuðust bakteríur í 1253 sýnum frá 974 börnum á tímabilinu, 647 sýni frá drengjum og 606 frá stúlkum. Flestar jákvæðar ræktanir voru hjá börnum á fyrsta aldursári (594; 47,4%) og þar af voru 252 hjá nýburum (42,4% barna á fyrsta aldursári). Kóagúlasaneikvæðir stafýlókokkar ræktuðust í 465 tilfellum. Af þeim ræktunum sem flokkuðust sem sýkingar voru Streptococcus pneumoniae algengastar (103 tilfelli), Staphylococcus aureus (94 tilfelli) og Neisseria meningitidis (72 tilfelli). Ekki ræktaðist N. meningitidis af hjúpgerð C hjá neinu barni eftir að bólusetning barna hófst árið 2002. Algengustu hjúpgerðir pneumókokka hjá börnum á Íslandi voru 23, 6B, 7, 19 og 14. Ónæmi fyrir makrólíðum var hátt hjá pneumókokkum (19%) og streptókokkum af flokki A (33%). Ályktun: Niðurstöðurnar gefa mikilvægar upplýsingar fyrir meðhöndlun barna með alvarlegar sýkingar og fyrirbyggjandi aðgerðir. Vaxandi ónæmi fyrir makrólíðum hindrar notkun þeirra við blinda meðferð hjá börnum með sýklasótt. Niðurstöður rannsóknarinnar sýna frábæran árangur bólusetningar barna gegn meningókokkum C auk þess sem þær gefa vísbendingu um mögulega gagnsemi af bólusetningum gegn ákveðnum hjúpgerðum pneumókokka

Febrile Children with Pneumonia Have Higher Nasopharyngeal Bacterial Load Than Other Children with Fever

Funding Information: A research grant was obtained from the Nordic Society for Infectious Diseases and Clinical Microbiology (SSAC Foundation, ref: SLS-780471). Publisher Copyright: © 2023 by the authors.Febrile episodes are common in children and the most frequent reason for attending emergency services. Although most infections have a benign and self-limiting course, severe and sometimes life-threatening infections occur. This prospective study describes a cohort of children presenting to a single-centre pediatric emergency department (ED) with suspected invasive bacterial infection, and explores the relationships between nasopharyngeal microbes and outcomes. All children attending the ED who had a blood culture taken were offered to participate over a two-year period. In addition to conventional medical care, a nasopharyngeal swab was obtained., which was analysed for respiratory viruses and three bacterial species using a quantitative PCR. Fisher's exact test, Wilcoxon rank sum, and multivariable models were used for statistical analyses of the 196 children (75% younger than four years) who were enrolled and had sufficient data for analysis; 92 had severe infections according to the study protocol, while five had bloodstream infections. Radiologically confirmed pneumonia was the most common severe infection found in 44/92 patients. The presence of respiratory viruses and the carriage of Streptococcus pneumoniae and Haemophilus influenzae were associated with a higher risk of pneumonia. Higher density colonisation with these bacteria were independent risk factors for pneumonia, whereas Moraxella catarrhalis carriage was associated with lower risk. Our data support the hypothesis that higher nasopharyngeal density of pneumococci and H. influenzae could play a role in the development of bacterial pneumonia in children. A preceding viral infection of the respiratory tract may be a trigger and play a role in the progression to severe lower respiratory tract infection.Peer reviewe

SARS-CoV-2 Infections in Icelandic Children : Close Follow-up of All Confirmed Cases in a Nationwide Study

Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.Introduction: Children are less likely to acquire SARS-CoV-2 infections than adults and when infected, usually have milder disease. True infection and complication rates are, however, difficult to ascertain. In Iceland, a strict test, trace and isolate policy was maintained from the start of the pandemic and offers more accurate information of the number of truly infected children in a nationwide study. Material and methods: All children with positive PCR for SARS-CoV-2 infections from February 28, 2020 to August 31, 2021 were followed up through telephone consultations for at least 14 days and their symptoms were registered. Symptom severity and duration were categorized based on age groups and the source of infection was registered. Results: A total of 1749 children were infected with SARS-CoV-2 in 3 waves of infections. All waves had similar disease severity whereas the incidence was 5-fold higher in the third wave (3.5 vs. 0.73/1000 children/month). No children had severe symptoms, 81 (4.6%) had moderate symptoms, 1287 (73.9%) had mild and 374 (21.5%) were asymptomatic. Symptoms from upper (n = 839, 48%) and lower respiratory tract (n = 744, 43%) were most common. Median duration of symptoms was 5 days and adolescents had a higher risk of prolonged duration [OR:1.84 (1.39-2.43)]. Nineteen (1.1%) children needed medical attention, but no child was hospitalized. The source of infection was a household member in 65% of cases. Discussion: During the first 3 waves of the pandemic, SARS-CoV-2 infections in Icelandic children were mild and none were hospitalized. The most common symptoms were respiratory symptoms followed by fever, headache and tiredness. This study helps shed light on true complication rates of children with confirmed SARS-CoV-2 infection.Peer reviewe

Continuous increase of immunoglobulin therapy in Iceland

Peer reviewe

Effect of dietary fish-oil on survival of experimental animals after infection with Streptococcus pneumoniae or Klebsiella pneumoniae

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: Dietary fish-oil has beneficial effect in infections and in autoimmune disorders. This effect is thought to be associated with alterations in the immune system. The Gram negative organism Klebsiella pneumoniae has been used as an infective agent in most studies investigating the effect of dietary fish-oil on infection. The immune response against Gram positive bacteria is somewhat different to the response to Gram negative oeganisms. Moreover, the Gram positive bacteria Streptococcus pneumoniae is a very common pathogen, particularly in children. To investigate whether dietary fish-oil has different effect in infections by Gram positive or Gram negative bacteria, we studied the survival of mice fed with fish-oil or corn-oil supplemented diets and infected in the lungs with either Klebsiella pneumoniae or Streptococcus pneumoniae. Materials and methods: 120 NMRI mice were divided into four groups and fed diets supplemented with fish-oil (two groups, 30 mice in each group) or corn-oil (two groups, 30 mice in each group). After six weeks, the mice were infected with Klebsiella pneumoniae (fish-oil group and corn-oil group) or with Streptococcus pneumoniae serotype 3 (fish-oil group and corn-oil group). The survival was monitored. The experiment was performed twice. Results: The survival of the mice infected with Klebsiella pneumoniae was significantly better in the groups receiving the fish-oil enriched diet as compared to the groups fed the corn-oil enriched diet (p=0.0001 and 0.0013). There was no difference in the survival of mice infected with Streptococcus pneumoniae serotype 3, receiving the fish-oil or corn-oil enriched diets (p=0.74 and p=0.15). Conclusions: These results indicate that dietary fish-oil has beneficial effect on survival of mice after experimental infection with the Gram negative bacteria Klebsiella pneumoniae but not on experimental infections with the Gram positive bacteria Streptococcus pneumoniae serotype 3.Markmið: Áhrif lýsisneyslu á lifun eftir sýkingar og á sjálfnæmissjúkdóma hefur verið staðfest af ýmsum rannsóknarhópum. Talið er að áhrifin megi rekja til breytinga á ónæmissvari líkamans. Flestar rannsóknanna hafa verið gerðar með Gram neikvæðu bakteríunni Klebsiella pneumoniae. Ónæmissvarið gegn Gram jákvæðum bakteríum er nokkuð frábrugðið svari gegn Gram neikvæðum bakteríum. Þá er Gram jákvæða bakterían Streptococcus pneumoniae mjög algengur sýkingavaldur, einkum í börnum. Til að kanna hvort verndandi áhrif lýsisneyslu séu mismunandi eftir því hvort sýkt er með Gram jákvæðum eða Gram neikvæðum bakteríum rannsökuðum við áhrif lýsisríks fæðis á lifun músa eftir sýkingar með Klebsiella pneumoniae eða Streptococcus pneumoniae. Efniviður og aðferðir: 120 NMRI músum var skipt í fjóra hópa og voru aldar á fæði bættu með lýsi (tveir hópar, 30 mýs í hvorum hópi) eða á fæði bættu með kornolíu (tveir hópar, 30 mýs í hvorum hópi). Eftir sex vikur voru mýsnar sýktar með Klebsiella pneumoniae (lýsishópur og kornolíuhópur) eða með Streptococcus pneumoniae hjúpgerð 3 (lýsishópur og kornolíuhópur). Fylgst var með lifun músanna. Tilraunin var síðan endurtekin á sama hátt. Niðurstöður: Lifun músa sem sýktar voru með Klebsiella pneumoniae var marktækt betri hjá hópunum sem fengu lýsisríkt fæði samanborið við hópana sem fengu kornolíubætt fæði (p=0,0001 og 0,0013). Ekki var tölfræðilega marktækur munur á lifun músa sem sýktar voru með Streptococcus pneumoniae hjúpgerð 3 hvort heldur þær fengu lýsisríkt eða kornolíuríkt fæði (p=0,74 og p=0,15). Ályktanir: Niðurstöður okkar benda til þess að áhrif lýsisríks fæðis tilraunadýra séu greinileg þegar sýkt er með Gram neikvæðu bakteríunni Klebsiella pneumoniae en ekki í sýkingum með Streptococcus pneumoniae hjúpgerð 3

Beneficial effect of dietary fish-oil is independent of the infection site

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: Fish-oil enriched diet has a protective effect on experimental animals infected intramuscularly with Klebsiella pneumoniae. It also has beneficial effect in several other diseases, including autoimmune disorders. The pathophysiological effects of dietary fish-oil have still not been revealed although it is expected to influence the immune response. We have previously shown that dietary fish-oil has beneficial effect in mice infected intramuscularly with Klebsiella pneumoniae. If the beneficial effect of dietary fish-oil is due to influence on the immune response it should be independent of the infection site. We therefore investigated whether dietary fish-oil has beneficial effect in intrapulmonary infection with Klebsiella pneumoniae as it has on intramuscular infection with the same bacteria. Materials and methods: Sixty NMRI mice were fed diets enriched with fish-oil (30 mice) or corn-oil (30 mice) for six weeks. The mice were then infected in the lungs with Klebsiella pneumoniae and the survival was monitored. The experiment was performed twice. The results were compared to our earlier results with intramuscular infections. Results: The survival of the mice fed the fish-oil enriched diet and infected in the lungs with Klebsiella pneumoniae was significantly better compared to the survival of mice fed the corn-oil enriched diet in both experiments (p=0.0001 and p=0.0013). These results are similar to our earlier findings when the mice were infected intramuscularly. Conclusions: These results indicate that the beneficial effect of dietary fish-oil on infection is independent of the site of infection. These results are in accordance with the hypothesis that dietary fish-oil influences the immune response.Markmið: Lýsisríkt fæði hefur verndandi áhrif á tilraunadýr sem sýkt eru í vöðva með Klebsiella pneumoniae og hefur einnig áhrif í ýmsum sjúkdómum, þar á meðal sjálfnæmissjúkdómum. Ekki er ljóst á hvern hátt lýsið virkar þó líklegt sé að virknin tengist áhrifum lýsis á ónæmissvar dýranna við sýkingunum og öðru áreiti. Rannsóknarhópurinn hefur áður birt niðurstöður sem sýna verndandi áhrif lýsisneyslu í sýkingum með Klebsiella pneumoniae þegar bakteríunni er sprautað í vöðva. Ef verndandi áhrif lýsis í sýkingum tengjast almennt ónæmissvari líkamans ættu þau að koma fram óháð íkomustað sýkingarinnar. Í tilraunum okkar nú var því kannað hvort lýsið hefði sömu verndandi áhrif á tilraunadýr sem sýkt voru í lungu í stað vöðva eins og það gerði í fyrri tilraunum. Efniviður og aðferðir: Sextíu NMRI mýs voru aldar í sex vikur á fæði bættu með lýsi (30 mýs) eða fæði bættu með kornolíu (30 mýs). Eftir það voru mýsnar sýktar í lungu með Klebsiella pneumoniae og fylgst með lifun. Tilraunin var síðan endurtekin á nákvæmlega sama hátt. Niðurstöðurnar voru bornar saman við fyrri tilraunir hópsins þar sem sýkt var í læri. Niðurstöður: Lifun músa sem fengið höfðu lýsisbætt fæði var marktækt betri í báðum tilraununum samanborið við mýs sem aldar voru á kornolíubættu fæði (p=0,0001 og p=0,0013). Niðurstöðurnar eru sambærilegar fyrri niðurstöðum þegar sýkt var í vöðva. Ályktanir: Niðurstöðurnar benda til að jákvæð áhrif lýsisneyslu komi fram óháð íkomustað bakteríanna. Niðurstöðurnar eru því í samræmi við þá kenningu að lýsisneyslan hafi áhrif á ónæmissvar líkamans fremur en afmarkaða staðbundna þætti

Henoch-Schönlein purpura, patients admitted to Landspítali-University Hospital 1984-2000

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: Henoch-Schönlein purpura is a disease of small vessels which primarily affects children. The epidemiology of Henoch-Schönlein purpura in Iceland is not known. The main purpose of the study was to find out the incidence of the disease in Iceland and gather further epidemiological information. Patients and methods: All patients diagnosed with Henoch-Schönlein purpura during the years 1984-2000 and were admitted to the Children's Hospital Iceland, Landspítali Hringbraut as well as the paediatric department at the Landspítali Fossvogi were included in the study cohort. Information was gathered from medical records. The temporal relationship between the incidende of Henoch-Schönlein purpura and epidemics of three common infectious diseases was explored. Results: A total of 101 patients were found to have Henoch-Schönlein purpura, 51 females and 50 males. The incidence of Henoch-Schönlein purpura in Iceland is therefore approximately six cases annually. The mean age at diagnosis was 5.4 years. In addition to the rash, 72.3% had arthralgia and 45.5% abdominalia, 36.6% had hematuria or proteinuria during the hospitalization and 5.9% had severe renal involvement. The disease was more common in the winter months (Nov. - April) compared to the summer months (May - Oct.) (p=0.045). Conclusions: The epidemiology of Henoch-Schönlein purpura in Iceland is comparable to other countries. The disease was most common in children aged 2-5 years, which could reflect a common infection in the community as a part of the pathogenesis. Older children may have antibodies against these infections resulting in a decreased incidence of the disease. Our results support the theory that infection may play an important role in the pathogenesis of Henoch-Schönlein purpura. However, some abnormalities or variations in the immune response are probably also involved.Tilgangur: Henoch-Schönlein purpura er sjúkdómur sem einkennist af æðabólgu og kemur fyrst og fremst fram hjá börnum. Faraldsfræði Henoch-Schönlein purpura á Íslandi er ekki þekkt. Tilgangur rannsóknarinnar var því að kanna nýgengi sjúkdómsins á Íslandi auk þess að afla annarra faraldsfræðilegra upplýsinga. Sjúklingar og aðferðir: Allir sjúklingar 16 ára og yngri sem fengið höfðu greininguna Henoch-Schönlein purpura á tímabilinu 1984-2000 og voru lagðir inn á Barnaspítala Hringsins eða barnadeild Landspítala Fossvogi (áður SHR og Landakotsspítali) mynduðu rannsóknarhópinn. Safnað var upplýsingum úr sjúkraskrám um einkenni og rannsóknarniðurstöður. Sveiflur í tíðni sjúkdómsins voru bornar saman við sveiflur nokkurra þekktra smitsjúkdóma. Niðurstöður: Alls greindist 101 sjúklingur með Henoch-Schönlein purpura á tímabilinu, 51 stúlka og 50 drengir. Nýgengi Henoch-Schönlein purpura virðist svipað á Íslandi og víðast annars staðar, eða um sex tilfelli á ári. Meðalaldur var 5,4 ár. Auk útbrotanna reyndust 72,3% hafa liðverki og 45,5% kviðverki, 36,6% höfðu blóðmigu eða prótínmigu á meðan á sjúkrahúsvist stóð og 5,9% fengu alvarlegan nýrnasjúkdóm. Sjúkdómurinn var algengari á vetrarmánuðum (nóvember-apríl) en á sumarmánuðum (maí-október) (p= 0,045). Ályktanir: Faraldsfræði Henoch-Schönlein purpura hjá börnum á Íslandi virðist vera svipuð og í öðrum löndum. Áhugavert er að sjúkdómurinn er algengastur meðal barna tveggja til fimm ára og gæti það endurspeglað að algeng sýking eða sýkingar séu einn af orsakavöldum hans. Þegar börnin eldast og öðlast mótefni gegn slíkum sýkingum dregur úr tíðni sjúkdómsins. Mögulegt er að sýkingar séu einn þáttur í ferli sem ræsir sjúkdóminn en að auki þurfi ákveðin samsetning ónæmiskerfis að vera til staðar

Bacteremia in children with tumors or malignant diseases 1991-2000

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenIntroduction: Ten to twelve children with tumors or malignant diseases are diagnosed annually in Iceland. Cancer treatment can cause severe immune suppression, which makes the patients susceptible to serious infections. The aim of the current study was to evaluate sepsis in children with tumors or haematological malignancies, describe the types of bacteria cultured and their antibiotic susceptibilities, and collect information on associated risk factors. Materials and methods: This was a retrospective study on all children 0-15 years of age in Iceland who were diagnosed with a tumor or malignant disease between 1991 and 2000. Information was gathered on diagnosis, treatment, blood cultures, blood tests, antibiotic use, presence of foreign bodies (such as CVC) and survival. Results: Hundred-and-eighteen children were diagnosed with cancer or benign central nervous system (CNS) tumors in Iceland during the period 1991-2000. Central nervous system tumors were most common (N=28, 23.7%), leukemia (N=21, 17.8%) and lymphoma (N=17, 14%) were the second and third. The mean age at diagnosis was 5.9 years. Sufficient data was found in the hospital records on 99 children who were included in the study. Five hundred and twenty two blood cultures were drawn from 51 of the 99 children during the period. The mean number of blood cultures per patient was 14.8 for children with leukemia, but 2.6 for children with solid tumors. Of all blood cultures, 63.6% were from a central venous catheter or a Port-A Catheter , 5% from a peripheral site, but 30% were undisclosed. Of the 522 blood cultures, 90 grew bacteria (17.2%). Coagulase-negative staphylococci were isolated from 53 blood cultures (60%) and Staphylococcus aureus from 12 (13%). Positive cultures were regarded as a definite or possible infection in 47 blood cultures (52%), contamination in 17 (18.9% ), but uncertain in 26 (27.7%). Over 60 percent of the blood cultures (N=302) were drawn when a child was neutropenic (ANCInngangur: Árlega greinast 10-12 börn með æxli og illkynja sjúkdóma á Íslandi. Meðferð við illkynja sjúkdómum eykur hættu á alvarlegum sýkingum sem mikilvægt er að bregðast rétt við. Markmið rannsóknarinnar var að meta blóðsýkingar í börnum með æxli og illkynja sjúkdóma, þar með talið einstakar bakteríur og sýklalyfjanæmi þeirra. Áhættuþættir voru einnig kannaðir. Efniviður og aðferðir: Rannsóknin var aftur-skyggn og var rannsóknarþýðið öll börn á aldrinum 0-15 ára greind með illkynja sjúkdóm eða æxli á árunum 1991-2000 á Barnaspítala Hringsins. Upplýsingum var safnað um greiningu, meðferð, blóðræktanir, blóðgildi og fleira, svo sem sýklalyfjanotkun, aðskotahluti og afdrif. Niðurstöður: Alls greindust 118 börn með illkynja sjúkdóm eða æxli á tímabilinu. Æxli í miðtaugakerfi (MTK) voru algengust (N=28, 23,7%), þá hvítblæði (N=21, 17,8%) og eitlakrabbamein (N=17, 14%). Meðalaldur barna við greiningu var 5,9 ár. Upplýsingar úr sjúkraskrám voru fullnægjandi fyrir 99 börn. Af þeim var 51 barn blóðræktað. Fjöldi blóðræktana var 522. Meðalfjöldi blóðræktana var 14,8 hjá börnum með hvítblæði, en 2,6 hjá börnum með föst æxli. Blóðræktanir voru teknar úr holæðalegg eða lyfjabrunni í 63,6%, 5,4% úr útbláæð en 31% tilfella voru ótilgreind. Af 522 ræktunum voru 90 jákvæðar (17,2%). Algengasta bakterían var kóagúlasa-neikvæður stafýlókokkur (KNS) (N=53, 60%), en Staphylococcus aureus næstalgengastur (N=12, 13,3%). Jákvæð ræktun var talin tengjast líklegri eða sannaðri sýkingu í 47 tilfellum (52%), mengun í 17 (18,9%) en óvíst var með 26 ræktanir (27,7%). Barn hafði daufkyrningafæð (ANC ?1,0 *109/L) við 302 blóðræktanir (61,4%). Meðallengd daufkyrningafæðar var 9,0 dagar. C-reative protein (CRP) var að meðaltali 63,9 mg/L við blóðræktun og meðalhiti var 38,8 °C. Í 183 tilfellum var barn á sýklalyfjum við blóðræktun (35,1%). Rannsóknarniðurstöður barna með jákvæða blóðræktun voru ekki frábrugðnar öðrum. Ályktanir: Sýkingar af völdum Gram-jákvæðra baktería, sérstaklega KNS, eru nú mun algengari en Gram-neikvæðra baktería. Hluti jákvæðra ræktana getur þó verið mengun. Blóðrannsóknir virðast hafa lítið forspárgildi um niðurstöður blóðræktana. Ekkert barn lést úr blóðsýkingu af völdum baktería á tímabilinu. Reynslusýklalyfjameðferð hérlendis virðist enn árangursrík

Meningococcal carriage in children and young adults : a cross-sectional and longitudinal study, Iceland, 2019 to 2021

BackgroundNeisseria meningitidis is a commensal bacterium which can cause invasive disease. Colonisation studies are important to guide vaccination strategies.AimThe study's aim was to determine the prevalence of meningococcal colonisation, duration of carriage and distribution of genogroups in Iceland.MethodsWe collected samples from 1 to 6-year-old children, 15-16-year-old adolescents and 18-20-year-old young adults. Carriers were sampled at regular intervals until the first negative swab. Conventional culture methods and qPCR were applied to detect meningococci and determine the genogroup. Whole genome sequencing was done on groupable meningococci.ResultsNo meningococci were detected among 460 children, while one of 197 (0.5%) adolescents and 34 of 525 young adults (6.5 %) carried meningococci. Non-groupable meningococci were most common (62/77 isolates from 26/35 carriers), followed by genogroup B (MenB) (12/77 isolates from 6/35 carriers). Genogroup Y was detected in two individuals and genogroup W in one. None carried genogroup C (MenC). The longest duration of carriage was at least 21 months. Serial samples from persistent carriers were closely related in WGS.ConclusionsCarriage of pathogenic meningococci is rare in young Icelanders. Non-groupable meningococci were the most common colonising meningococci in Iceland, followed by MenB. No MenC were found. Whole genome sequencing suggests prolonged carriage of the same strains in persistent carriers.Peer reviewe