Philipp Foessleitner1, Julia Gasser1, Herbert Kiss1, Albert Flunt2, Elisabeth Presterl3, Ljubomir Petricevic4, Alex Farr1. 1. Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria. 2. Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria. 3. Department of Infection Control and Hospital Epidemiology, Medical University of Vienna, Vienna, Austria. 4. Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria. Electronic address: ljubomir.petricevic@meduniwien.ac.at.
Abstract
OBJECTIVE: Extended-spectrum beta-lactamase (ESBL) is a rapidly evolving enzyme that cleaves beta-lactam-containing antibiotics, forming resistance to certain types of antibiotics, such as penicillin, cephalosporins and monobactams. Colonization with ESBL-producing bacteria during pregnancy is harmful, however this topic is currently underrepresented in the literature. STUDY DESIGN: Using a retrospective design, we analyzed data of all consecutive pregnant women who were identified with a vaginal colonization of ESBL-producing bacteria from 2011 to 2016 at the Medical University of Vienna, Department of Obstetrics and Gynecology. Swabs were taken during pregnancy and/or at delivery, as well as from neonates. Demographic and clinical data were obtained from the central in-house alert system and patients' clinical records. RESULTS: Of the 14,279 deliveries performed in our department during the study period, we identified 13 women with vaginal colonization of ESBL-producing bacteria during pregnancy. Of these cases, 6 born neonates were tested ESBL positive. The maternal-to-neonatal transmission rate was 43 %, associated with a 70 % rate of preterm premature rupture of the membranes (pPROM) and a preterm birth rate of 83 %. Of the 6 neonates with ESBL colonization, 4 neonates (67 %) were born to mothers who were still tested positive at the time of delivery. CONCLUSION: Maternal colonization of ESBL-producing bacteria is an important risk factor for transmission. The vaginal presence of ESBL-producing bacteria during pregnancy is associated with preterm birth and pPROM, which shows the need for clear diagnostic and therapeutic guidelines.
OBJECTIVE: Extended-spectrum beta-lactamase (ESBL) is a rapidly evolving enzyme that cleaves beta-lactam-containing antibiotics, forming resistance to certain types of antibiotics, such as penicillin, cephalosporins and monobactams. Colonization with ESBL-producing bacteria during pregnancy is harmful, however this topic is currently underrepresented in the literature. STUDY DESIGN: Using a retrospective design, we analyzed data of all consecutive pregnant women who were identified with a vaginal colonization of ESBL-producing bacteria from 2011 to 2016 at the Medical University of Vienna, Department of Obstetrics and Gynecology. Swabs were taken during pregnancy and/or at delivery, as well as from neonates. Demographic and clinical data were obtained from the central in-house alert system and patients' clinical records. RESULTS: Of the 14,279 deliveries performed in our department during the study period, we identified 13 women with vaginal colonization of ESBL-producing bacteria during pregnancy. Of these cases, 6 born neonates were tested ESBL positive. The maternal-to-neonatal transmission rate was 43 %, associated with a 70 % rate of preterm premature rupture of the membranes (pPROM) and a preterm birth rate of 83 %. Of the 6 neonates with ESBL colonization, 4 neonates (67 %) were born to mothers who were still tested positive at the time of delivery. CONCLUSION: Maternal colonization of ESBL-producing bacteria is an important risk factor for transmission. The vaginal presence of ESBL-producing bacteria during pregnancy is associated with preterm birth and pPROM, which shows the need for clear diagnostic and therapeutic guidelines.