Colonization Of Mothers Research Articles

Comparison of risk factors for Methicillin Resistant Staphylococcus aureus (MRSA) colonization in healthy newborns, born to mothers with and without MRSA colonization.

To compare the risk factors for MRSA colonization in healthy newborns, born of mothers with and without MRSA colonization. This case control study was conducted in post-natal unit of Lady Willingdon Hospital, affiliated with King Edward Medical University/Mayo Hospital, Lahore from January to June 2017. The vaginal and anterior nares swabs for MRSA culture were collected from mothers within six hours before planned delivery and the neonatal anterior nares swabs for MRSA culture were taken within one hour of birth. All the samples were cultured in Paediatric Microbiology laboratory in Mayo Hospital. Data were analyzed through SPSS 20.0 and logistic regression was applied for risk factors analysis. Out of total 80 mothers and their newborns, 15 (18.75%) mothers and 16 neonates (20%) were MRSA colonized. The frequency of MRSA colonization in mothers' anterior nares and vaginal swab was 17.5% and 1.25% respectively. The significant risk factors were prolonged rupture of membranes for >18 hours (p-value 0.02, odds ratio 11.85, 95% CI 1.41-99.3), birth weight <2500 grams (p-value 0.01, odds ratio 5.39, 95% CI 1.35-21.4), history of presence of meconium (p-value 0.006, odds ratio 7.30, 95% CI 1.78-29.8). The non-significant factors were age of mother (p-value 0.682, odds ratio 0.765, 95% CI 1.0.212-2.76), parity (p-value 0.185, odds ratio 3.82, 95% CI 0.46-31.66) , gestation (p-value 0.615, odds ratio 0.797, 95% CI 0.714-0.89) , mode of delivery (p-value 0.576, odds ratio 0.543, 95% CI 0.062-4.76), sex of baby (p-value 0.546, odds ratio 0.683, 95% CI 0.196-2.37) and presentation of baby at birth (p-value 0.47, odds ratio 0.795, 95% CI 0.71-0.89). The presence of meconium, prolonged rupture of membranes and low birth weight were the significant risk factors for MRSA colonization in healthy new-borns, born to mothers with and without MRSA colonization.

Clinical Profile and Risk Factors of Group B Streptococcal Colonization in Mothers from the Eastern District of China.

Objective The main aim of this study was to determine the prevalence, capsular genotyping, antimicrobial susceptibility, and associated factors of colonizing Group B Streptococcus (GBS) in pregnant women admitted to a hospital in Jinan, East China. Methods Demographic data, clinical characteristics, and vaginal and rectal swabs were obtained from a group of expecting mothers subjected to GBS screening at the late stage of pregnancy who went into labor over the period from November 2019 to October 2020. Identification of GBS and determination of antimicrobial resistance patterns were performed using a BD Phoenix-100 system. Capsular genotypes were analyzed using polymerase chain reaction and the associated factors were evaluated via logistic regression. Result A total of 2761 pregnant women were recruited for this study. The GBS colonization rate was 6.70% (185/2761). Among the 172 GBS strains examined, all were susceptible to vancomycin and linezolid. Resistance was the highest for erythromycin (80.2%), followed by clindamycin (75.0%), levofloxacin (65.1%), and tetracycline (57.6%). The most common serotype identified was Ia (61.0%), followed by III (29.7%), VI (4.6%), II (3.5%), VII (0.6%), and a nontypeable strain. Risk factors for maternal GBS colonization included maternal age (older than 30 years) (OR = 1.913 (1.662, 2.478)), gestational age at birth (average gestational age) (OR = 1.992 (1.445, 2.746)), and prelabor rupture of membrane (OR = 3.838 (1.619, 9.099)). Conclusion The prevalence of GBS was relatively low. The maternal age was a factor associated with GBS colonization. Subjects showing GBS positivity during late pregnancy were prone to prolonged rupture of the membrane (PROM) and birth at lower a gestation age than the GBS-negative group. Penicillin could still be used as the first agent of choice for intrapartum antibiotic prophylaxis (IAP).

Clinical Profile and Outcome of Group B Streptococcal Colonization in Mothers and Neonates in Ras Al Khaimah, United Arab Emirates: A Prospective Observational Study.

Background:Maternal Group B Streptococcus (GBS)/Streptococcus agalactiae colonization rates vary worldwide; however, no such recent data are available from the United Arab Emirates (UAE).Objective:The objective of this study was to determine the prevalence of GBS colonization among pregnant women attending an antenatal clinic of a hospital in Ras Al Khaimah, UAE, along with the antibiotic sensitivity pattern, the clinical profile and pregnancy (maternal and fetal) outcome.Methods:This prospective observational study routinely offered rectovaginal swab for GBS to all women attending the antenatal clinic at 35–37 weeks of pregnancy between January and December 2019. MASTASTREP kit and Vitek-2 identification system was used for culture and identification. Women with positive cultures were followed up for any maternal and neonatal complications and the use of intrapartum antibiotic prophylaxis (IAP).Results:A total of 2295 women were included, of which 158 (6.9%) had positive cultures for GBS colonization. The carriage rate was higher in women without any risk factors for early-onset GBS disease (EOGBS) (P < 0.01). The GBS isolates were about 97% susceptible to linezolid and vancomycin, 90% to benzyl penicillin and 95% to ampicillin. Resistance to trimethoprim/sulfamethoxazole, clindamycin, erythromycin, and levofloxacin were about 77%, 57%, 57%, and 10%, respectively. Urinary tract infection in GBS colonized women were more common in those aged ≤30 years (P = 0.009). Fetal outcome was favorable in women receiving IAP for GBS colonization. No neonate had culture proven EOGBS.Conclusion:The prevalence of GBS colonization in pregnant women as well as the overall maternal and neonatal complications is low in Ras Al Khaimah, UAE. IAP is effective in preventing early-onset sepsis in newborn, and thus should be initiated in those with GBS colonization. The cultured GBS showed sensitivity to most antibiotics.

Prevalence and Risk Factor for Antibiotic-resistant Escherichia coli Colonization at Birth in Premature Infants: A Prospective Cohort Study.

Escherichia coli causes neonatal early-onset sepsis (EOS) that is associated with high mortality and increasing antibiotic resistance. Thus, we estimated the prevalence, antibiotic susceptibility and risk factors for colonization of E. coli in premature infants at birth and characterized the pathogenicity of the isolates. A prospective surveillance study was conducted at three Japanese perinatal centers between August 2014 and February 2017. Infants weighing <2 kg and/or at gestational age <35 weeks at birth were enrolled. We screened the mothers and neonates for E. coli colonization. Pulsed-field gel electrophoresis was used to analyze the relatedness between the maternal and neonatal isolates. Virulence factors for the isolates were determined using polymerase chain reaction. We enrolled 421 premature infants born to 382 mothers. The rate of colonization in mothers was 47.6%, comprising 5.9% extended-spectrum beta-lactamase-producing E. coli (ESBL-E) and 20.0% ampicillin-resistant strains. Ten (2.4%) infants exhibited colonization; ESBL-E and ampicillin-resistant strains colonized three and four infants, respectively. Three antibiotic-resistant, strain-positive infants developed EOS. Pulsed-field gel electrophoresis revealed vertical transmission of bacteria in four infants. Multivariate logistic regression analysis revealed that ESBL-E-positive mothers [odds ratio (OR), 19.2; 95% confidence interval (CI), 2.5-145.7)] and vaginal delivery (OR, 9.4; 95% CI, 1.7-50.7) were risk factors for neonatal colonization. The infant isolates possessed numerous virulence factors. Although the prevalence of E. coli-colonized premature infants at birth was low, the rate of antibiotic resistance and the attack rate for EOS were high. Infants with ESBL-E positive mothers should be closely monitored for EOS.

The Pglyrp1-Regulated Microbiome Enhances Experimental Allergic Asthma.

Changes in intestinal or respiratory microbiomes in infants correlate with increased incidence of asthma, but the causative role of microbiome in the susceptibility to asthma and the host genes that regulate these changes in microbiome are mostly unknown. In this study, we show that decreased responsiveness to allergic asthma in Pglyrp1 -/- mice (lacking bactericidal peptidoglycan recognition protein 1) could be transferred to germ-free wild-type mice by colonization of mothers and newborns with microbiota from Pglyrp1 -/- mice. These colonized mice had decreased airway resistance and fewer inflammatory cells, less severe histopathology, and lower levels of IgE and proallergic cytokines and chemokines in the lungs. This microbiome-dependent decreased responsiveness to asthma was most pronounced in colonized germ-free BALB/c mice (genetically predisposed to asthma), only partially evident in outbred germ-free Swiss Webster mice, and marginal in conventional BALB/c mice following depletion of microbiome with antibiotics. Mice with a low asthmatic response colonized with microbiota from Pglyrp1 -/- mice had increased abundance of Bacteroidetes and decreased abundance of Firmicutes, Tenericutes, Deferribacteres, and Spirochaetes in the feces and increased abundance of Pasteurella in the oropharynx. These changes in bacterial abundance in the feces and oropharynx correlated with lower asthmatic responses in the lungs. Thus, our results show that Pglyrp1 enhances allergic asthmatic responses primarily through its effect on the host intestinal microbiome and identify several bacteria that may increase or decrease sensitivity to asthma. This effect of microbiome is strong in asthma-prone BALB/c mice and weak in asthma-resistant outbred mice and requires germ-free conditions before colonization with microbiota from Pglyrp1 -/- mice.

Prevalence of oropharyngeal group B Streptococcus colonization in mothers, family, and health care providers.

ObjectiveTo determine the prevalence and serotype of oropharyngeal Group B Streptococcal (GBS) colonization of mothers, their family & friends, and health care providers of recently delivered patients as a potential reservoir of neonatal exposure to GBS.MethodsThis is a prospective, single-center observational study of: (1) patients, (2) their family and friends, and (3) health care providers all of whom may come in close contact with neonates. Oropharyngeal GBS colonization and serotype was determined.ResultsThree hundred and seventy three samples were collected. The prevalence of oropharyngeal GBS colonization among all study participants was 23.1% (N = 86). The most commonly found serotypes were 1b (12.8%, N = 11), III (27.9%, N = 24), and V (17.4%, N = 15). The prevalence of oropharyngeal GBS colonization among mothers was 26% (N = 31/121), 22% (N = 39/178) in family and friends, and 21.6% (N = 16/74) in health care providers.ConclusionGroup B Streptococcus colonizes the oropharynx in 1 in 5 mothers, family and friends, and health care providers who come in direct contact with neonates. Further research is needed to determine if this potential reservoir for neonatal exposure could lead to early or late onset neonatal GBS colonization or infection.

Group B streptococcal colonization in mothers and infants in western China: prevalences and risk factors

BackgroundThe epidemiology of maternal and infant Group B streptococcus (GBS) colonization is poorly understood in China. The aim of this study is to explore the prevalence and risk factors associated with maternal and infant GBS colonization in Western China.MethodsFrom January 2017 to June 2017, a prospective study was conducted to estimate the maternal and infant GBS colonization rate by maternal rectovaginal and infant nasopharynx, ear canal and umbilical swab culture. Patient demographics, clinical characteristics and outcomes were collected. Chi-square and logistic regression analyses were used to examine the risk factors associated with GBS colonization of mothers and infants.ResultsThe GBS colonization rate in mothers and infants was 6.1 and 0.7%, respectively. The vertical transmission rate was 7.6%. The early onset GBS infection rate was 0.58 per 1000 live births and mortality was 0.29 per 1000 live births. Age younger than 40 years (p = 0.040) and minority ethnic status (p = 0.049) were associated with higher GBS colonization rate in pregnant women. Positive GBS status in the mother prior to delivery (p < 0.001) as well as longer duration of membrane rupture (≥12 h) (p < 0.001) and longer labor (≥4 h) (p < 0.001) were all significant risk factors for GBS colonization in infants. Compared to infants without GBS colonization, infants colonized with GBS were more likely to have had a temperature of ≥38 °C (p < 0.001), developed early onset infection (EOD) (p < 0.001), and been prescribed antibiotics (p < 0.001). Furthermore, infants with GBS were more likely to have been admitted to neonatal intensive unit (NICU) (p < 0.001) with a longer hospital length of stay (LOS) (p < 0.001).ConclusionsMaternal GBS colonization, longer duration of membrane rupture and labor were all major risk factors associated with GBS colonization in Chinese infants. Infant GBS colonization was associated with increased risk of EOD and NICU admission as well as longer LOS.

Comparison between Different Types of Surveillance Samples for the Detection of GBS Colonization in Both Parturient Mothers and Their Infants

Objective: To find the optimum screening method in detecting group B streptococcal (GBS) colonization in both mother and infant, and to identify the risk factors that influence GBS colonization in the infants. Patients and Methods: 1,120 singleton pregnant women were evaluated for GBS colonization by combined lower vaginal-anorectal swabs (LVRS) and urine tests, while their infants were evaluated for colonization with skin, ear and gastric aspirate samples. Results: LVRS swabs were positive in 14.2% of mothers while urine was positive in 7.6%. Among the infants skin, ear and gastric aspirate samples were positive in 7.0, 6.9 and 3.5%, respectively. Prolonged rupture of the membrane was the only significant factor associated with colonization in these infants (p < 0.001). Conclusions: Lower vaginal-anorectal swab is an effective method in detecting colonization in mothers especially when combined with urine culture. Skin or ear swabs are equally effective in detecting colonization in neonates. GBS colonization rate in our parturient and neonatal population is comparable to that was reported from other countries. A well-developed screening program and appropriate management strategies for both GBS colonized mothers and infants are recommended.

Prevalence and risk factors of streptococcus agalactiae (group b) colonization in mothers and their neonates at srinagarind hospital, Khon Kaen, Thailand

International Journal of Gynecology & ObstetricsVolume 70, Issue S3 p. C103-C103 Panel Infections in obstertrics and gynecology Prevalence and risk factors of streptococcus agalactiae (group b) colonization in mothers and their neonates at srinagarind hospital, Khon Kaen, Thailand Y. Werawatakul, Y. WerawatakulSearch for more papers by this authorC. Wilailuckana, C. WilailuckanaSearch for more papers by this authorS. Taksaphan, S. TaksaphanSearch for more papers by this authorJ. Thinkumrup, J. ThinkumrupSearch for more papers by this author Y. Werawatakul, Y. WerawatakulSearch for more papers by this authorC. Wilailuckana, C. WilailuckanaSearch for more papers by this authorS. Taksaphan, S. TaksaphanSearch for more papers by this authorJ. Thinkumrup, J. ThinkumrupSearch for more papers by this author First published: 11 December 2003 https://doi.org/10.1016/S0020-7292(00)80674-8AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume70, IssueS32000Pages C103-C103 RelatedInformation

Trimethoprim-resistant Escherichia coli in households of children attending day care centers.

Children in day care centers are frequently colonized with trimethoprim-resistant Escherichia coli. The frequency of transmission to family members was studied. Colonization with trimethoprim-resistant E. coli was detected in 13 (57%) of 23 day care center children. Among the 50 (98%) of 51 household members tested, colonization was detected in 13 (26%), representing 12 (52%) of 23 households tested. Households of colonized center children had significantly more colonized members than did households of noncolonized children (odds ratio, 13.3; 95% confidence interval, 1.3-172.6; P = .01). There was a trend toward higher prevalence of colonization in mothers (35%) and siblings (30%) than in fathers (12%). The same plasmid profiles of trimethoprim-resistant E. coli from center children were found among 8 (67%) of 12 colonized households. There was no association between antibiotic use and fecal colonization with trimethoprim-resistant E. coli. Thus, transmission of trimethoprim-resistant E. coli among children within day care centers and from center children to household members is common.

EPIDEMIOLOGY OF GROUP B STREPTOCOCCI (GBS) IN MOTHERS AND INFANTS

The incidence of neonatal GBS disease in Israel is strikingly low. As neonatal GBS colonization and disease directly relates to maternal GBS carriage, we sampled the maternal and infant Jerusalem population for GBS colonization and surveyed GBS neonatal disease to ascertain the epidemiologic relationships. As GBS serotypes vary in their virulence we also analyzed the prevalence of the different serotypes of GBS isolates. In 1984, GBS colonization of 254 Jewish women and 189 Arab women was 5.4% and 1.6% respectively. In 1987 the rate in 116 Jewish women was 3.5%. Colonization of infants from the same mothers was 1.8%, 1.3% and 1.1% respectively. Differences between these rates was not significant. GBS neonatal disease for the period 1982-1987 was 0.2/1000 live births. Serotype distribution from 150 isolates was Type I 45%, Type II 17%, Type III 13%, other 24%. Our data documenting the low prevalence of GBS colonization in mothers and infants and the low incidence of neonatal GBS disease supports the hypothesis that maternal GBS colonization is the major determinant of GBS neonatal disease. Furthermore the low prevalence of the virulent GBS serotype III may further explain the low attack rate.

1040 ENUMERATION OF GROUP B STREPTOCOCCI (GBS) IN COLONIZED INFANTS

It is unknown why only 1 in 100 colonized infants develop GBS disease. There have been several semiquantitative studies of colonization in mothers, but no quantitative studies on magnitude of colonization in infants. This study was designed to determine if infants symptomatic for early-onset GBS disease (respiratory distress) are heavily colonized with the bacteria. Newborn infants suspected of early-onset disease at Tampa General Hospital were cultured at three or more sites with CulturetteR dual swabs. The swabs were used for identification of GBS by slide co-agglutination and enumeration of the bacteria by viable plate count. Eleven (13%) of 85 infants cultured were found to be colonized with GBS at one or more sites. Two of these eleven colonized infants were symptomatic for early-onset GBS disease. Both symptomatic infants were heavily colonized (≥2.9 × 103 bacteria/swab) with GBS of serotype I. In comparison, only one of the nine asymptomatic infants was colonized with GBS of serotype I and the colonization was of a low magnitude (<2.0 × 101 bacteria/swab). The other eight infants were colonized with nontype I GBS, generally at low numbers. The two asymptomatic infants that were heavily colonized with GBS were colonized with bacteria of serotype III. These preliminary data suggest a possible correlation between heavy colonization of neonates with specific serotypes of GBS and the development of early-onset group B disease.

Nosocomial Transmission of Group B Streptococci in a Newborn Nursery

Group B streptococcal colonization of normal newborn infants increased from 22.5% within 20 hours of birth to 65.4% at the time of hospital discharge (P less than .001). In contrast, colonization in mothers did not change significantly between the time of admission to labor and delivery (27.7%) and the time of discharge (31.1%). Epidemiologic data suggested but did not prove that the mode of nosocomial transmission of group B streptococci among infants was cross colonization via personnel contact.

Pathogenesis of neonatal Escherichia coli meningitis: induction of bacteremia and meningitis in infant rats fed E. coli K1

Escherichia coli K1 strains, isolated from human newborns with meningitis, were fed to pathogen-free Sprague-Dawley infant rats by an oral gastric tube. Feeding of 10(3) to 10(11) organisms colonized the intestine of approximately 70% of the animals. At 5 days postfeeding of 3- to 5-day-old rats, bacteremia was detected in 60%, and meningitis occurred in 15% of bacteremic animals. Colonization and bacteremia were age-related. Rats 15 days old had only 19 colonization and 10% bacteremia, and those 30 days old were almost completely resistant to colonization and bacteremia. The intranasal route was less effective in inducing colonization and bacteremia. Intralitter transmission from E. coli K1-fed rats occurred, with 52% of water-fed controls becoming colonized and 15% become bacteremic. Colonization of mothers from their fed infants occurred, but none of five tested developed bacteremia. Other E. coli capsular polysaccharide types were studied. A K92 strain isolated from a newborn with meningitis induced a 77% colonization rate, and 8% of these developed bacteremia without detectable meningitis. An E. coli K100 strain showed a 32% colonization rate, and 2% developed bacteremia. The age relation, relatively high virulence of K1 compared with other capsular types, spontaneous appearance of colonization, bacteremia, and meningitis, and intralitter transmission of colonization and disease in newborn rats closely parellel E. coli epidemiology in human neonates.

NEONATAL STAPHYLOCOCCAL INFECTION

The dynamics, consequences, and prevention of neonatal staphylococcal colonization were studied in San Salvador, El Salvador. The results indicate that: All untreated infants who resided in the hospital for more than 48 hours became colonized. Umbilical preceded nasal colonization in this group. An antiseptic skin care program effectively prevented colonization among treated infants in the hospital. Colonization in this group did occur in the first 3 months of life, but never to the extent found among the controls. Nasal preceded umbilical colonization in the treated group. Staphylococcal disease occurred four times as frequently in the control group as in the treated group and four times as often in males as in females. Initial staphylococcal colonization in mothers and family members of the two study groups and the non-staphylococcal disease experiences of both populations were essentially identical. Therefore, the differences in colonization rates and staphylococcal disease among the infants were probably due to the infant care program. Studies on the epidemiology of neonatal staphylococcal infection and disease in San Salvador were carried out from birth through the first 3 months of life. The phage-types and antibiograms of hospital- and community-derived strains differed widely from each other. The excess morbidity encountered in untreated infants was traceable almost entirely to hospitalacquired infections. The first strain acquired by an infant was not necessarily the disease-producing strain, and multiple sequential colonizations occurred among the infants and their mothers. All hospital-acquired strains persisted and declined at approximately the same rate throughout the study.