Peripartum maternal transmission of extended-spectrum β-lactamase organism to newborn infants

Peretz, Avi; Skuratovsky, Alina; Khabra, Efrat; Adler, Amos; Pastukh, Nina; Barak, Shay; Perlitz, Yuri; Ben‐Ami, Moshe; Kushnir, Amir

doi:10.1016/j.diagmicrobio.2016.11.004

Cited by 18 publications

(15 citation statements)

References 26 publications

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“…Maternal colonization could also be investigated since maternal vertical transmission of ESBL organisms to newborns could be one of the transmission modes. 40…”

Section: Discussionmentioning

confidence: 99%

Clonal relatedness in the acquisition of intestinal carriage and transmission of multidrug resistant (MDR) Klebsiella pneumoniae and Escherichia coli and its risk factors among preterm infants admitted to the neonatal intensive care unit (NICU)

Lee

Kamar

Velayuthan

et al. 2021

Pediatrics & Neonatology

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“…Maternal colonization could also be investigated since maternal vertical transmission of ESBL organisms to newborns could be one of the transmission modes. 40…”

Section: Discussionmentioning

confidence: 99%

Clonal relatedness in the acquisition of intestinal carriage and transmission of multidrug resistant (MDR) Klebsiella pneumoniae and Escherichia coli and its risk factors among preterm infants admitted to the neonatal intensive care unit (NICU)

Lee

Kamar

Velayuthan

et al. 2021

Pediatrics & Neonatology

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“…Several studies have identified the 3GCRB-colonized mother as substantial risk factor for colonization of the neonate [4,6,9,10,24,25]. Recent data of the German surveillance system for nosocomial infection in preterm infants on neonatal wards (NEO-KISS) indicate that 8.45 % of neonatal colonizations with multidrug-resistant gram-negative bacteria were brought in by colonized mothers [21].…”

Section: Discussionmentioning

confidence: 99%

Screening for Third-Generation Cephalosporin-Resistant Bacteria Reduces the Incidence on Late-Onset Sepsis and Antibiotic use in Neonates

et al. 2020

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Background The extensive use of antibiotics is reflected by an increasing prevalence of infections with multidrug-resistant bacteria, including third-generation cephalosporin-resistant bacteria (3GCRB). For neonatal intensive care units screening and enhanced barrier precautions are recommended to control the spread of multidrug-resistant Gram-negative bacteria, while evidence for efficacy of barrier precautions remains scarce in a non-outbreak setting. Objective To determine the impact of a screening program for maternal 3GCRB colonization and the effects of contact precautions and cohort nursing, concerning the risk of neonatal late-onset sepsis (LOS) and antibiotic use rates (AURs). Study Design In a retrospective matched-pair cohort study, data of neonates exposed to maternal 3GCRB colonization were compared with findings in non-exposed neonates. Results Of 3,144 neonates admitted, 184 neonates born to 3GCRB-positive mothers were eligible. Among them, 37 (20%) became 3GCRB positive during hospital stay. 3GCRB-exposed infants had a lower rate of LOS (6.5 vs. 14.1%, p=0.03) and lower AURs in that time period compared to controls (mean 0.009 vs. 0.025, p=0.006). When started within the first 72h after birth, days of therapy with meropenem were significantly lower in non-exposed vs. 3GCRB-exposed infants (mean 0.13 vs. 0.42; p=0.002). No invasive infections with 3GCRB occurred. Conclusions Neonates of 3GCRB-positive mothers do not have an increased a priori risk for invasive 3GCRB infection and may benefit from enhanced contact precautions measures.

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“…In these settings, there are very few data from the community and the majority of published studies estimated a prevalence (ranging from 10.0% to 46.0%) which is less accurate than an incidence [ 12 , 23 , 26 , 32 – 36 ]. In addition, most studies [ 37 – 40 ] on the acquisition of ESBL-PE were conducted in neonatal intensive care units where ESBL-PE are more likely to be hospital-acquired and where neonates have serious illness, are more exposed to broad-spectrum antibiotics and are thus not representative of the general population. In these studies, two swabs were usually performed: the first one at admission and the second one at discharge which does not allow an accurate incidence estimation.…”

Section: Discussionmentioning

confidence: 99%

Acquisition of extended spectrum beta-lactamase-producing enterobacteriaceae in neonates: A community based cohort in Madagascar

et al. 2018

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In low and middle income countries (LMICs), where the burden of neonatal sepsis is the highest, the spread of extended spectrum beta-lactamase-producing enterobacteriaceae (ESBL-PE) in the community, potentially contributing to the neonatal mortality, is a public health concern. Data regarding the acquisition of ESBL-PE during the neonatal period are scarce. The routes of transmission are not well defined and particularly the possible key role played by pregnant women. This study aimed to understand the neonatal acquisition of ESBL-PE in the community in Madagascar. The study was conducted in urban and semi-rural areas. Newborns were included at birth and followed-up during their first month of life. Maternal stool samples at delivery and six stool samples in each infant were collected to screen for ESBL-PE. A Cox proportional hazards model was performed to identify factors associated with the first ESBL-PE acquisition. The incidence rate of ESBL-PE acquisition was 10.4 cases/1000 newborn-days [95% CI: 8.0–13.4 cases per 1000 newborn-days]. Of the 83 ESBL-PE isolates identified, Escherichia coli was the most frequent species (n = 28, 34.1%), followed by Klebsiella pneumoniae (n = 20, 24.4%). Cox multivariate analysis showed that independent risk factors for ESBL-PE acquisition were low birth weight (adjusted Hazard-ratio (aHR) = 2.7, 95% CI [1.2; 5.9]), cesarean-section, (aHR = 3.4, 95% CI [1.7; 7.1]) and maternal use of antibiotics at delivery (aHR = 2.2, 95% CI [1.1; 4.5]). Our results confirm that mothers play a significant role in the neonatal acquisition of ESBL-PE. In LMICs, public health interventions during pregnancy should be reinforced to avoid unnecessary caesarean section, unnecessary antibiotic use at delivery and low birth weight newborns.

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Peripartum maternal transmission of extended-spectrum β-lactamase organism to newborn infants

Cited by 18 publications

References 26 publications

Clonal relatedness in the acquisition of intestinal carriage and transmission of multidrug resistant (MDR) Klebsiella pneumoniae and Escherichia coli and its risk factors among preterm infants admitted to the neonatal intensive care unit (NICU)

Clonal relatedness in the acquisition of intestinal carriage and transmission of multidrug resistant (MDR) Klebsiella pneumoniae and Escherichia coli and its risk factors among preterm infants admitted to the neonatal intensive care unit (NICU)

Screening for Third-Generation Cephalosporin-Resistant Bacteria Reduces the Incidence on Late-Onset Sepsis and Antibiotic use in Neonates

Acquisition of extended spectrum beta-lactamase-producing enterobacteriaceae in neonates: A community based cohort in Madagascar

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