Mother-to-child transmission of extended-spectrum-beta-lactamase-producing Enterobacteriaceae. Issue 1 (September 2018)

• Record Type: Journal Article
• Authors: Danino, D.; Melamed, R.; Sterer, B.; Porat, N.; Hazan, G.; Gushanski, A.; Shany, E.; Greenberg, D.; Borer, A.
• Is Part Of: Journal of hospital infection. Volume 100:Issue 1(2018)
• Page Start: 40
• Page End: 46
• Publication Date: 2018-09
• Subjects: ESBL -- Colonization -- Preterm infants -- Mother-to-child transmission; Cross infection -- Periodicals; Cross infection -- Prevention -- Periodicals; Nosocomial infections -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Cross Infection -- Periodicals; Cross Infection -- prevention & control -- Periodicals; Infection Control -- Periodicals; Electronic journals; 614.44
• DOI: 10.1016/j.jhin.2017.12.024
• Languages: English
• ISSNs: 0195-6701

Abstract

Summary: 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.