The mother as most important risk factor for colonization of very low birth weight (VLBW) infants with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E)
The mother as most important risk factor for colonization of very low birth weight (VLBW) infants with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E)
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DOI：
10.1093/jac/dku097
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发表时间：
2014-08-01
影响因子：
5.2
通讯作者：
Piening, Brar
中科院分区：
文献类型：
--
作者：
Denkel, Luisa A.;Schwab, Frank;Piening, Brar
本研究旨在确定极低出生体重(VLBW；<；1500 g)婴儿及其母亲中产超广谱β-内酰胺酶肠杆菌(ESBL-E)和耐甲氧西林金黄色葡萄球菌(MRSA)的患病率及其定植危险因素。用ESBL-E和MRSA对极低出生体重儿及其母亲进行定植筛查。从德国全国极低出生体重儿医院感染监测系统(NEO-KISS)获得人口学和临床数据，并进行单因素和多因素分析。209例ESBL-E检测的新生儿中有18例(8.6%)与ESBL-E阳性母亲有关。单变量分析、菌株分型和多变量分析(OR 7.4，95%CI 2.1-26.7，PaEuroS=aEuroS0.002)确定ESBL-E阳性母亲和母婴传播是定植的主要来源。221例极低出生体重儿中MRSA感染率为2.3%(5/221)。在221名(0.5%)MRSA检测的新生儿中，有一名与MRSA阳性的母亲有关。本研究未检测到MRSA传播的危险因素。我们的研究表明，母婴传播ESBL-E是极低出生体重儿定植的重要危险因素。因此，新生儿和母亲的常规ESBL-E筛查应被视为降低新生儿发病率和死亡率的一种手段。
This study aimed to determine the prevalence of and risk factors for colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) and methicillin-resistant Staphylococcus aureus (MRSA) in very low birth weight (VLBW; < 1500 g) infants and their mothers.This investigation was conducted in the perinatal centre at the Charit, Berlin between May 2012 and June 2013. VLBW infants and their mothers were screened for colonization with ESBL-E and MRSA. Demographic and clinical data were obtained from the German nationwide surveillance system for nosocomial infections in VLBW infants (NEO-KISS) and used to perform univariate and multivariate analyses.Of 209 VLBW infants, 12 (5.7%) were colonized with ESBL-E. Eighteen of 209 (8.6%) ESBL-E-tested neonates were related to an ESBL-E-positive mother. Univariate analysis, strain typing and multivariate analysis (OR 7.4, 95% CI 2.1-26.7, PaEuroS=aEuroS0.002) identified an ESBL-E-positive mother and maternal-neonatal transmission as a main source of colonization. The prevalence of MRSA was 2.3% (5 of 221) among VLBW infants. One of the 221 (0.5%) MRSA-tested neonates was related to an MRSA-positive mother. No risk factors for transmission of MRSA could be detected in this study.Our study demonstrated that maternal-neonatal transmission of ESBL-E from mother to child is an important risk factor for colonization of VLBW infants. As a consequence, routine ESBL-E screening of neonates and mothers should be considered as a means of reducing neonatal morbidity and mortality.