S Rettedal1, I H Löhr2, E Bernhoff2, O B Natås2,3, A Sundsfjord4,5, K Øymar1,6. 1. Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway. 2. Department of Medical Microbiology, Stavanger University Hospital, Stavanger, Norway. 3. Department of Infection Control, Stavanger University Hospital, Stavanger, Norway. 4. Department of Medical Biology, University of Tromsø, Stavanger, Norway. 5. Norwegian National Advisory Unit on Detection of Antimicrobial Resistance, University Hospital of North Norway, Tromsø, Norway. 6. Department of Clinical Science, University of Bergen, Bergen, Norway.
Abstract
OBJECTIVE: To study (i) the prevalence and risk factors for carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) in pregnant women, (ii) the maternal-neonatal transmission rate of ESBL-E at birth and (iii) the prevalence of ESBL-E in expressed breast milk of colonized mothers. STUDY DESIGN: In this cross-sectional, population-based study with case follow-up on maternal-neonatal transmission of ESBL-E, women were screened for rectal ESBL-E colonization at 36 weeks of pregnancy and delivery. Possible risk factors for colonization were studied by logistic regression. Infants of ESBL-E-positive mothers were screened for ESBL-E during their first weeks of life. ESBL-encoding genes were detected by PCR and clonal relatedness was investigated by pulsed-field gel electrophoreses. RESULTS: In total, 26 out of 901 (2.9%) women were colonized by ESBL-producing Escherichia coli at 36 weeks of pregnancy. One of the women carried an additional ESBL Klebsiella pneumoniae strain. Adjusted for traveling, African or Asian nationality was a risk factor for colonization; OR=5.62 (2.21, 14.27) (LR-p=0.003). Fourteen women remained ESBL-E carriers at delivery. ESBL-E strains indistinguishable from the strains isolated from their respective mothers were detected in 5 (35.7%) infants during their first days of life (median day 3; range=2 to 8). A total of 146 expressed milk samples were cultured from 25 out of 26 colonized mothers, all were ESBL-E negative. CONCLUSIONS: The prevalence of ESBL-E carriage among pregnant women was low in our region, but the high maternal-neonatal transmission rate suggests that colonized mothers represent a substantial risk for infant colonization.
OBJECTIVE: To study (i) the prevalence and risk factors for carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) in pregnant women, (ii) the maternal-neonatal transmission rate of ESBL-E at birth and (iii) the prevalence of ESBL-E in expressed breast milk of colonized mothers. STUDY DESIGN: In this cross-sectional, population-based study with case follow-up on maternal-neonatal transmission of ESBL-E, women were screened for rectal ESBL-E colonization at 36 weeks of pregnancy and delivery. Possible risk factors for colonization were studied by logistic regression. Infants of ESBL-E-positive mothers were screened for ESBL-E during their first weeks of life. ESBL-encoding genes were detected by PCR and clonal relatedness was investigated by pulsed-field gel electrophoreses. RESULTS: In total, 26 out of 901 (2.9%) women were colonized by ESBL-producing Escherichia coli at 36 weeks of pregnancy. One of the women carried an additional ESBL Klebsiella pneumoniae strain. Adjusted for traveling, African or Asian nationality was a risk factor for colonization; OR=5.62 (2.21, 14.27) (LR-p=0.003). Fourteen women remained ESBL-E carriers at delivery. ESBL-E strains indistinguishable from the strains isolated from their respective mothers were detected in 5 (35.7%) infants during their first days of life (median day 3; range=2 to 8). A total of 146 expressed milk samples were cultured from 25 out of 26 colonized mothers, all were ESBL-E negative. CONCLUSIONS: The prevalence of ESBL-E carriage among pregnant women was low in our region, but the high maternal-neonatal transmission rate suggests that colonized mothers represent a substantial risk for infant colonization.
Authors: M Zamfir; A C Adler; S Kolb; A Dammeyer; L Nasri; L Schomacher; B Karlin; M Franitza; S Hörmansdorfer; C Tuschak; G Valenza; U Ochmann; C Herr Journal: Eur J Clin Microbiol Infect Dis Date: 2017-05-04 Impact factor: 3.267
Authors: Charlotte R Ulstad; Margrete Solheim; Sophie Berg; Morten Lindbæk; Ulf R Dahle; Astrid L Wester Journal: Antimicrob Resist Infect Control Date: 2016-12-15 Impact factor: 4.887
Authors: Nguyen Thanh Viet; Vu Van Du; Nghiem Duc Thuan; Hoang Van Tong; Nguyen Linh Toan; Can Van Mao; Nguyen Van Tuan; Srinivas Reddy Pallerla; Dennis Nurjadi; Thirumalaisamy P Velavan; Ho Anh Son Journal: Antibiotics (Basel) Date: 2021-05-13
Authors: J Seni; A A Mwakyoma; F Mashuda; R Marando; M Ahmed; R DeVinney; J D D Pitout; S E Mshana Journal: BMC Pediatr Date: 2019-01-26 Impact factor: 2.125