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Mother-to-child transmission of extended-spectrum-beta-lactamase-producing Enterobacteriaceae.
J Hosp Infect. 2018 Sep; 100(1):40-46.JH

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.

Authors+Show Affiliations

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.Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; Paediatric Infectious Disease Unit, Soroka University Medical Centre, Beer Sheva, Israel.Infection Control and Hospital Epidemiology Unit, Soroka University Medical Centre, Beer Sheva, Israel.Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; Paediatric Infectious Disease Unit, Soroka University Medical Centre, Beer Sheva, Israel.Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; Paediatric Infectious Disease Unit, Soroka University Medical Centre, Beer Sheva, Israel.Infection Control and Hospital Epidemiology Unit, Soroka University Medical Centre, Beer Sheva, Israel.Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; Neonatal Intensive Care Unit, Soroka University Medical Centre, Beer Sheva, Israel.Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; Paediatric Infectious Disease Unit, Soroka University Medical Centre, Beer Sheva, Israel.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.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29330015

Citation

Danino, D, et al. "Mother-to-child Transmission of Extended-spectrum-beta-lactamase-producing Enterobacteriaceae." The Journal of Hospital Infection, vol. 100, no. 1, 2018, pp. 40-46.
Danino D, Melamed R, Sterer B, et al. Mother-to-child transmission of extended-spectrum-beta-lactamase-producing Enterobacteriaceae. J Hosp Infect. 2018;100(1):40-46.
Danino, D., Melamed, R., Sterer, B., Porat, N., Hazan, G., Gushanski, A., Shany, E., Greenberg, D., & Borer, A. (2018). Mother-to-child transmission of extended-spectrum-beta-lactamase-producing Enterobacteriaceae. The Journal of Hospital Infection, 100(1), 40-46. https://doi.org/10.1016/j.jhin.2017.12.024
Danino D, et al. Mother-to-child Transmission of Extended-spectrum-beta-lactamase-producing Enterobacteriaceae. J Hosp Infect. 2018;100(1):40-46. PubMed PMID: 29330015.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mother-to-child transmission of extended-spectrum-beta-lactamase-producing Enterobacteriaceae. AU - Danino,D, AU - Melamed,R, AU - Sterer,B, AU - Porat,N, AU - Hazan,G, AU - Gushanski,A, AU - Shany,E, AU - Greenberg,D, AU - Borer,A, Y1 - 2018/01/10/ PY - 2017/11/05/received PY - 2017/12/25/accepted PY - 2018/1/14/pubmed PY - 2018/11/6/medline PY - 2018/1/14/entrez KW - Colonization KW - ESBL KW - Mother-to-child transmission KW - Preterm infants SP - 40 EP - 46 JF - The Journal of hospital infection JO - J. Hosp. Infect. VL - 100 IS - 1 N2 - 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. SN - 1532-2939 UR - https://www.unboundmedicine.com/medline/citation/29330015/Mother_to_child_transmission_of_extended_spectrum_beta_lactamase_producing_Enterobacteriaceae_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0195-6701(18)30036-7 DB - PRIME DP - Unbound Medicine ER -