Vertical Transmission of Extended-Spectrum, Beta-Lactamase-Producing Enterobacteriaceae during Preterm Delivery: A Prospective Study
Open Access
- 26 February 2021
- journal article
- research article
- Published by MDPI AG in Microorganisms
- Vol. 9 (3), 506
- https://doi.org/10.3390/microorganisms9030506
Abstract
Maternal carriage and vertical transmission of extended-spectrum, beta-lactamase-producing Enterobacteriaceae (ESBL-E), such as Escherichia coli, hamper the treatment of infections, resulting in high morbidity. E. coli is the most frequent cause of early-onset neonatal sepsis (EOS) in preterm infants, where ESBL-E are more frequently isolated. In this prospective, case-controlled study, maternal rectovaginal ESBL-E colonization and vertical transmission to preterm infants were assessed in 160 women with preterm premature rupture of membranes (PPROM; 57.4%) or preterm labor (42.6%); additional cultures were obtained from the placenta, amnion, and umbilical cord during preterm labor. Maternal and neonatal ESBL-E-carriage rates were 17.5% and 12.9%, respectively, and the vertical-transmission rate was 50%. Maternal ESBL-E colonization among women with PPROM was 21.3%, and in women with premature labor it was 12.6%. No correlation was observed between maternal ESBL-E-colonization and previous hospitalization or antibiotic administration during pregnancy. However, a correlation was found between placental inflammation and maternal ESBL-E colonization (p = 0.007). ESBL-E-colonized infants were delivered at an earlier gestational age and were more likely to have complications. Thus, the high ESBL-E carriage rate in women with threatened preterm labor, without obvious risk factors for carriage, and a high vertical transmission rate, combined with a correlation between placental inflammation and ESBL-E carriage, support maternal–neonatal ESBL-E-colonization surveillance and active measures to prevent ESBL-E-related EOS.Keywords
This publication has 34 references indexed in Scilit:
- Nationwide epidemiology of early‐onset sepsis in Israel 2010‐2015, time to re‐evaluate empiric treatmentActa Paediatrica, 2019
- Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysisThe Lancet. Global Health, 2018
- Characterisation and antimicrobial resistance of sepsis pathogens in neonates born in tertiary care centres in Delhi, India: a cohort studyThe Lancet. Global Health, 2016
- Bacterial Meningitis in InfantsClinics in Perinatology, 2014
- Early-Onset Neonatal SepsisClinical Microbiology Reviews, 2014
- Born Too Soon: The global epidemiology of 15 million preterm birthsReproductive Health, 2013
- Early Onset Neonatal Sepsis: The Burden of Group B Streptococcal and E. coli Disease ContinuesPediatrics, 2011
- Countdown to 2015 decade report (2000–10): taking stock of maternal, newborn, and child survivalThe Lancet, 2010
- Epidemiology and risk factors for early onset sepsis among very-low-birthweight infantsAmerican Journal of Obstetrics and Gynecology, 2009
- The Contribution of Preterm Birth to Infant Mortality Rates in the United StatesPediatrics, 2006