Carbapenemase-producing Enterobacteriaceae among pregnant women and newborns in Algeria: Prevalence, molecular characterization, maternal-neonatal transmission, and risk factors for carriage

Abstract

The diffusion of carbapenemase-producing Enterobacteriaceae (CPE) represents a worldwide public health problem. This study revealed that the prevalence of OXA-48-producing enterobacteria was 4.6% (19/414) and 1.6% (7/422) in mothers and newborns, respectively, from 2 maternity units in Algeria. Previous hospital admission was an independent factor associated with an increased risk of CPE carriage in the mothers (P = .021). The low birth weight was significantly associated with this carriage in the newborns (P = .008). The screening of these bacteria is essential to prevent the dissemination of CPE.

Carbapenem-Resistant Gram-Negative Bacterial Infections in Children

“…Although being born to a mother colonized with an extended-spectrum-␤lactamase-producing Enterobacterales strain increases the risk of colonization in the newborn (46,47), current data do not support significant mother-to-newborn transmission of CRE (48,49), with only one case (50) being reported so far. Therefore, there must be other risk factors related to colonization in these newborns.…”

Molecular Epidemiology, Risk Factors and Clinical Outcomes of Carbapenem- and Polymyxin-Resistant Gram-negative Bacterial Infections in Pregnant Women and Infants: A Systematic Review

“…In particular, neonates can become colonized and later infected with CR/PR-GNB during antibiotic therapy 23,68 , long-stay in wards (NICU) with endemic CR/PR-GNB 42,67 , handling by healthcare workers, breastfeeding by colonized mothers, intubation, during labour or caesarian section 24,65,66 , mechanized ventilation, from the community 23,61 etc. (Tables S1-S3).…”

“…Hence, the presence of MDR carbapenem and/or polymyxin-resistant infections among pregnant women and infants make them more susceptible to the ramifications of the infection 13,19,20 . Whereas several studies have reported on pregnant women colonized with CR-GNB than infected by it, there is a risk of colonized pregnant women transferring these CR-GNB to their new borns 19,[21][22][23][24] . It is therefore not surprising that numerous studies report on CR-GNB-and polymyxin-resistant Gram-negative bacteria (PR-GNB)-infected neonates than colonized ones 20,23,25,26 .…”

Performance of a new in-house medium Carba MTL-broth for the rapid detection of carbapenemase-producing Enterobacteriaceae

“…A panel of 140 clinical Gram-negative bacilli (GNB) isolates belonging to two collections from the regional multidrug-resistant GNB Reference Lab (the CARB-LR group) in the French Occitanie Region [18,19] and from the laboratory of microbial ecology of the University of Bejaia (Algeria) was tested (Table 1). One hundred thirteen Enterobacteriaceae isolates were included with the following distribution: Escherichia coli (n = 42), Klebsiella pneumoniae (n = 35), Enterobacter cloacae (n = 14), Klebsiella oxytoca (n = 6), Citrobacter freundii (n = 4), Enterobacter aerogenes (n = 3), Proteus mirabilis (n = 2), Morganella morganii (n = 1), Citrobacter werkmanii (n = 2), Citrobacter koseri (n = 1), Raoultella ornithinolytica (n = 1), Raoultella planticola (n = 1) and Pluralibacter gergoviae (n = 1).…”

“…All isolates were typed by the Check-MDR CT102/103 ® microarrays (Biocentric, Bandol, France). Confirmation of the presence of β-lactamase-encoding genes was done by PCRs using specific primers and confirmed by sequencing the PCR products as previously described [18][19][20][21][22]. Emerging resistance mechanisms (colistin resistance mcr-1 determinant and 16S rRNA methylase) were also characterized by PCR as previously described [23].…”