D Danino1, R Melamed2, B Sterer3, N Porat2, G Hazan2, A Gushanski3, E Shany4, D Greenberg2, A Borer5. 1. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; Paediatric Infectious Disease Unit, Soroka University Medical Centre, Beer Sheva, Israel. Electronic address: dudi@bgu.ac.il. 2. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; Paediatric Infectious Disease Unit, Soroka University Medical Centre, Beer Sheva, Israel. 3. Infection Control and Hospital Epidemiology Unit, Soroka University Medical Centre, Beer Sheva, Israel. 4. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; Neonatal Intensive Care Unit, Soroka University Medical Centre, Beer Sheva, Israel. 5. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; Infection Control and Hospital Epidemiology Unit, Soroka University Medical Centre, Beer Sheva, Israel.
Abstract
BACKGROUND: Preterm infants are at high risk for extended-spectrum-beta-lactamase-producing Enterobacteriaceae (ESBL-E) sepsis and neonatal intensive care unit (NICU) outbreaks. Maternal colonization with ESBL-E may be precursory to mother-to-child transmission. However, there is no consensus regarding surveillance of pregnant women for ESBL-E colonization. AIM: To identify pairs of mothers and infants harbouring same-strain ESBL-E colonization and to determine whether maternal transmission may play a role in increasing ESBL-E carriage in preterm infants. METHODS: This was a one-year analysis from an ongoing, prospective ESBL-E surveillance of mothers of premature infants and their offspring. Mother-infant pairs colonized with the same bacteria underwent strain analysis using pulsed-field gel electrophoresis (PFGE). Clinical parameters were collected from the hospital computerized records. FINDINGS: Between January 2015 and January 2016, 313/409 (76.5%) mothers and all 478 (100%) infants were screened for ESBL-E colonization; carriage rates were 21.5% and 14.8%, respectively. Four (5.6%) colonized infants developed late-onset sepsis and two (2.8%) died. Twenty-five mother-infant pairs colonized with the same bacterial strain were identified; a subgroup of 10 pairs of isolates underwent PFGE, and 70% displayed an identical PFGE fingerprint. No similarities were found between isolates recovered from unrelated neonates and mothers. ESBL-E colonization was found significantly earlier in infants of mothers colonized at birth (P<0.001) compared with infants of non-colonized mothers. CONCLUSIONS: ESBL-E carriage rates in mothers and NICU infants with non-negligible maternal-neonatal ESBL-E transmission in the study region indicate that maternal colonization surveillance and/or further infection control interventions should be considered.
BACKGROUND: Preterm infants are at high risk for extended-spectrum-beta-lactamase-producing Enterobacteriaceae (ESBL-E) sepsis and neonatal intensive care unit (NICU) outbreaks. Maternal colonization with ESBL-E may be precursory to mother-to-child transmission. However, there is no consensus regarding surveillance of pregnant women for ESBL-E colonization. AIM: To identify pairs of mothers and infants harbouring same-strain ESBL-E colonization and to determine whether maternal transmission may play a role in increasing ESBL-E carriage in preterm infants. METHODS: This was a one-year analysis from an ongoing, prospective ESBL-E surveillance of mothers of premature infants and their offspring. Mother-infant pairs colonized with the same bacteria underwent strain analysis using pulsed-field gel electrophoresis (PFGE). Clinical parameters were collected from the hospital computerized records. FINDINGS: Between January 2015 and January 2016, 313/409 (76.5%) mothers and all 478 (100%) infants were screened for ESBL-E colonization; carriage rates were 21.5% and 14.8%, respectively. Four (5.6%) colonized infants developed late-onset sepsis and two (2.8%) died. Twenty-five mother-infant pairs colonized with the same bacterial strain were identified; a subgroup of 10 pairs of isolates underwent PFGE, and 70% displayed an identical PFGE fingerprint. No similarities were found between isolates recovered from unrelated neonates and mothers. ESBL-E colonization was found significantly earlier in infants of mothers colonized at birth (P<0.001) compared with infants of non-colonized mothers. CONCLUSIONS: ESBL-E carriage rates in mothers and NICU infants with non-negligible maternal-neonatal ESBL-E transmission in the study region indicate that maternal colonization surveillance and/or further infection control interventions should be considered.
Authors: Katariina Thomson; Katarina Eskola; Marjut Eklund; Kristiina Suominen; Merita Määttä; Jouni Junnila; Suvi Nykäsenoja; Kati Niinistö; Thomas Grönthal; Merja Rantala Journal: Acta Vet Scand Date: 2022-02-09 Impact factor: 1.695