Prevalence of MRSA nasal carriage among pregnant women in Copenhagen

Holm, Mona Katrine Alberthe; Winther, Thilde Nordmann; Kammann, Sisse; Rasmusson, Marianne Skovby; Brooks, Lis; Westh, Henrik; Bartels, Mette Damkjær

doi:10.1371/journal.pone.0246343

Cited by 9 publications

(8 citation statements)

References 14 publications

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“…The introduction of MRSA to the NICU by colonized parents has often been discussed. The risk for introduction might vary due to the heterogeneous geographical MRSA burden; for instance, a very low MRSA prevalence among pregnant women was recently reported in Denmark [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and infection control of Methicillin-resistant Staphylococcus aureus in a German tertiary neonatal intensive and intermediate care unit: A retrospective study (2013–2020)

et al. 2022

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In preterm and term infants who require intermediate or intensive care Methicillin-resistant Staphylococcus aureus (MRSA) infection can lead to significant morbidity. In this study MRSA colonization and infection were assessed in a mixed tertiary neonatal intensive and intermediate care unit in Germany over an 8-year period (2013–2020). We investigated patient-related factors, associated with nosocomial MRSA acquisition, and we discuss our infection control concept for MRSA. Of 3488 patients treated during the study period, 24 were MRSA positive patients, corresponding to 26 patient hospital stays. The incidence was 0.7 MRSA patients per 100 patients. The incidence density was 0.4 MRSA patient hospital stays per 1000 patient days. Twelve patients (50%) acquired MRSA in the hospital. One patient developed a hospital acquired MRSA bloodstream infection 9 days after birth (i.e., 0.03% of all patients on the ward during the study period). A total of 122 patients had to be screened to detect one MRSA positive patient. In a logistic regression model, the use of 3rd generation intravenous cephalosporin (cefotaxim) was associated with nosocomial MRSA acquisition compared with matched control patients who did not acquire MRSA. In sum, the burden of MRSA colonization and infection in the ward was low during the study period. A comprehensive infection control concept that included microbiologic colonization screening, prospective infection surveillance together with isolation and emphasis on basic hygiene measures is essential to handle MRSA in this specialized setting.

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Section: Discussionmentioning

confidence: 99%

Epidemiology and infection control of Methicillin-resistant Staphylococcus aureus in a German tertiary neonatal intensive and intermediate care unit: A retrospective study (2013–2020)

et al. 2022

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“…Although there have not been many reports of TSS due to postpartum MRSA, routine anti-MRSA therapy is not recommended [ 26 ]. The possibility of infections in pregnant women during hospitalization after delivery has been reported to be 0.11% [ 73 ], and it is essential to consider the risk factors for MRSA infection in each healthcare setting. Therefore, anti-MRSA therapy should be evaluated based on each patient’s risk factors or in cases where MRSA colonization has already been observed in the past [ 74 ].…”

Section: Discussionmentioning

confidence: 99%

Acute heart failure associated with toxic shock syndrome due to methicillin-susceptible Staphylococcus aureus during the postpartum period: case report and systematic literature review

Suzuki

Matsuo

Kijima

et al. 2022

BMC Cardiovasc Disord

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Background Toxic shock syndrome (TSS) caused by Staphylococcus aureus in the postpartum period is a rare but life-threatening disease. We present a case of acute heart failure as the initial presentation of TSS due to methicillin-susceptible Staphylococcus aureus (MSSA) and describe its clinical characteristics with a systematic literature review. Case presentation A 34-year-old woman, 8 days after a normal vaginal delivery presented to our hospital with dyspnea and fever. She had jugular venous distension, bilateral leg edema, and erythema. Laboratory examinations revealed elevated NT-pro-BNP level of 3,233 pg/mL. Transthoracic echocardiography showed elevated tricuspid regurgitation peak gradient, with decreased respiratory variability of the inferior vena cava diameter and bilateral pleural effusions. The patient was hospitalized with suspicion of congestive heart failure. MSSA positive for toxic shock syndrome exotoxin-1 was detected in the culture of the perineal incision wound, and we diagnosed TSS caused by MSSA. Intravenous diuretics were administered, along with eventual cefazolin plus clindamycin. After 2 weeks of antimicrobial therapy, the patient showed improvement and was discharged. No recurrence was observed at the 24-month follow-up. Conclusion This is a rare case report of acute heart failure being the initial manifestation of TSS due to MSSA in the postpartum period. Clinicians should consider TSS as a possibility in postpartum patients with acute heart failure. This systematic review provides insights into its clinical features, treatment regimens, and prognosis of TSS by S. aureus in the postpartum period. TSS requires an appropriate, prompt diagnosis, because delayed treatment can be fatal.

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“…Similarly, we compared the prevalence of staphylococcal isolates recovered in patients of the African study with a history of vaginitis/ discharge, 66/146, i.e., 45.2% (p= 0.05) and the Chinese study reported 4/150, i.e., 2.7% (p= 0.81). A cross-sectional study conducted in Copenhagen, Denmark in 2021 (n=1778) reported quite contrasting results compared to the above Chinese and African reports [ 8 ]. Only two women, i.e., 0.11% were found to harbor MRSA .…”

Section: Reviewmentioning

confidence: 99%

“…Though it is widely hypothesized that outbreaks of MRSA infections primarily occur in the NICU after contact with colonized mothers or have been a nosocomial infection [ 8 ], recent studies have shown that infections have occurred and can occur even without exposure to healthcare settings or healthcare workers [ 9 ]. Reported data suggest that infant and maternal colonization of MRSA in the USA alone ranges from 1% to 4% which varies across different parts of the country, and it has also been stated that women of African ethnicity are more likely to have higher rates of colonization [ 4 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

The Potential Threat of Vertical Transmission in Methicillin-Resistant Staphylococcus Aureus Infection: A Systematic Review 2022

Allakky¹,

Ferguson²,

Khan³

et al. 2022

Cureus

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This systematic review paper aimed to assess and analyze the prevalence of maternal colonization of Staphylococcus aureus (S. aureus) also known as methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) in the peripartum period and its significance on vertical transmission to the neonate and if it is a potential threat to the health of newborns. For this, multiple databases, such as PubMed, MEDLINE, ScienceDirect, and the database of Elsevier, were used to scout for relevant articles, and results were reported adhering to the principles set by Preferred Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines 2020. A specific medical subject headings (MeSH) criterion was designed to search for relevant publications on PubMed. A total of 26 articles were finally selected after a meticulous screening process, including detailed inclusion and exclusion criteria, manual reading of titles and abstracts, and availability of accessible full-text articles. A few articles were also selected after going through the citations section of the initially selected papers. Quality appraisal was done on the selected publications.Maternal colonization of S. aureus is determined to be highly prevalent with the hypothesis that nasal colonization had higher rates than recto-vaginal sites. Increasing maternal age, history of vaginitis, and multiparity were the most common risk factors for MRSA and MSSA colonization. Premature babies were at the highest risk of MRSA colonization. Breast milk is also a risk factor for neonatal MRSA transmission. Through this systematic review, we concluded that although the rate of vertical transmission of MRSA is lower than that of MSSA, we felt that it held significance as neonates with the bug have poor outcomes due to skin and soft tissue infections and there is spread of MRSA to other neonates in the wards and spread to siblings in cases of triplets and quadruplets and even death due to potential MRSA sepsis. Women in Africa and China had high prevalence rates of MRSA and S. aureus which can probably be attributed to a lack of access to adequate healthcare facilities. We recommend screening with regular recto-vaginal swabs and nasal swabs especially in regions with a high burden of MRSA to be performed at regular intervals after confirmation of pregnancy, as prevention and screening are effective to avoid serious complications.

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Prevalence of MRSA nasal carriage among pregnant women in Copenhagen

Cited by 9 publications

References 14 publications

Epidemiology and infection control of Methicillin-resistant Staphylococcus aureus in a German tertiary neonatal intensive and intermediate care unit: A retrospective study (2013–2020)

Epidemiology and infection control of Methicillin-resistant Staphylococcus aureus in a German tertiary neonatal intensive and intermediate care unit: A retrospective study (2013–2020)

Acute heart failure associated with toxic shock syndrome due to methicillin-susceptible Staphylococcus aureus during the postpartum period: case report and systematic literature review

The Potential Threat of Vertical Transmission in Methicillin-Resistant Staphylococcus Aureus Infection: A Systematic Review 2022

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