Transmission of Staphylococcus aureus From Mothers to Newborns
Transmission of Staphylococcus aureus From Mothers to Newborns
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DOI：
10.1097/inf.0b013e318244020e
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发表时间：
2012-04-01
影响因子：
3.6
通讯作者：
Regev-Yochay, Gili
中科院分区：
文献类型：
--
作者：
Leshem, Eyal;Maayan-Metzger, Ayala;Regev-Yochay, Gili
背景：本研究的目的是确定金黄色葡萄球菌在母亲和新生儿之间传播的危险因素和途径。方法：对妊娠晚期妇女进行鼻腔和阴道金黄色葡萄球菌定植情况筛查。新生儿在出生时和出院前进行鼻腔、耳廓、脐带和直肠定植筛查。携带者母亲及其新生儿在 1 个月时接受重新筛查。使用脉冲场凝胶电泳来评估菌株遗传相关性。结果：在 208 名接受筛查的女性中，34% 的人感染了金黄色葡萄球菌。总体而言，到出生后 72-100 小时，携带者母亲的新生儿获得金黄色葡萄球菌的累积发生率为 42.6/100 例，而非携带者母亲的新生儿为 7.4/100 例（调整后的风险比 = 5.7；95% 置信区间 [CI]，2.3-13.9）。获得母体菌株的风险显着高于非母体菌株（调整后的风险比 = 1.5；95% CI，1.3-1.9）；与非携带者母亲的新生儿相比，携带者母亲的新生儿也有感染非母体金黄色葡萄球菌菌株的风险（调整后的风险比 = 2.9；95% CI，1.6-5.4）。剖腹产新生儿与阴道分娩新生儿的金黄色葡萄球菌累积发生率相似（24.5 vs. 23.0/100 例）。随访1个月时，携带者母亲的新生儿金黄色葡萄球菌累计发生率达到69.7/100。在32/40（80%）的母婴对中分离到基因相同的菌株，其中29/32（90%）的新生儿菌株来源是母体鼻部菌株。结论：携带者母亲的新生儿有获得金黄色葡萄球菌定植的风险。大多数携带者母亲的新生儿在出生后第一个月内就会被定植。来自母亲的水平传播可能是新生儿携带金黄色葡萄球菌的主要来源。
Background: The study objective was to define the risk factors and the route of Staphylococcus aureus transmission between mother and newborn.Methods: Women at late pregnancy were screened for nasal and vaginal S. aureus colonization. Newborns were screened for nasal, auricular, umbilical, and rectal colonization at birth and before discharge. Carrier mothers and their newborns were rescreened at 1 month. Pulse-field gel electrophoresis was used to assess strain genetic relatedness.Results: Of the 208 women screened, 34% were colonized with S. aureus. Overall, by 72-100 hours after birth, the cumulative incidence of S. aureus acquisition was 42.6/100 newborns of carrier mothers versus 7.4/100 newborns of noncarrier mothers (adjusted risk ratio = 5.7; 95% confidence interval [CI], 2.3-13.9). The risk to acquire a maternal strain was significantly higher than nonmaternal strain (adjusted risk ratio = 1.5; 95% CI, 1.3-1.9); Newborns to carrier mothers were also at a risk to acquire nonmaternal S. aureus strains compared with newborns to noncarrier mothers (adjusted risk ratio = 2.9; 95% CI, 1.6-5.4). The cumulative incidence of S. aureus acquisition was similar among newborns delivered by cesarean versus vaginal delivery (24.5 vs. 23.0/100 cases). At 1-month follow-up, the cumulative incidence of S. aureus acquisition reached 69.7/100 newborns of carrier mothers.Genetically identical strains were isolated in 32/40 (80%) mother-newborn pairs, among these, the source of the newborn strain was a maternal nasal strain in 29/32 (90%).Conclusions: Newborns of carrier mothers are at risk to acquire S. aureus colonization. Most newborns of carrier mothers are colonized within the first month of life. Horizontal transmission from the mother is probably the major source for S. aureus carriage in newborns.