Colonization by multidrug-resistant microorganisms of hospitalized newborns and their mothers in the neonatal unit context

Abstract

Introduction: The mother plays a fundamental role in the constitution and regulation of her child's healthy microbiota, however, preterm newborns are separated from their mothers soon after birth and transferred to Neonatal Intensive Care Units, being exposed the constant risk for the development of multidrug-resistant microorganisms’ infections. The aim of this study was to explore the multidrug-resistant microorganism colonization of hospitalized babies and their mothers in the neonatal unit context.
 Methodology: A prospective case study conducted with hospitalized babies and their mothers in the Neonatal Unit at a university hospital. The sample was composed of 433 binomials (mother-child). Colonization culture samples were taken at the moment of the baby’s discharge, via two swabs in the oral, nasal, axillary, inguinal, and rectal regions.
 Results: The colonization incidence among the binomials, 30 (6.9%) were both colonized by multi-resistant microorganisms. Mothers of colonized babies (24.4%) demonstrated a higher chance of colonization in comparison to mothers of non-colonized babies (11.9%) (p = 0.002). Relationships were drawn between baby colonization and prematurity, extremely low birth weight, and non-exclusive maternal breastfeeding (p<0.05). ESBL-producing Gram-negative microorganisms were more frequent in the cultures of the binomials, with 35.9% of the babies colonized with Klebsiella spp. ESBL and 42.0% of the mothers with Escherichia coli ESBL. Furthermore, 50% of the binomials were colonized with E. coli ESBL.
 Conclusion: The prematurity, extremely low birth weight, and non-exclusive breastfeeding at hospital discharge were associated with baby colonization by multidrug-resistant microorganism. Furthermore, mothers of colonized children presented higher chances of colonization.

Evaluating the Use of Neonatal Colonization Screening for Empiric Antibiotic Therapy of Sepsis and Pneumonia

“…However, Smith et al (2010) reported an association between vaginal delivery and bloodstream infection with GNB [14]. In contrast to the results of other studies, we did not find any association of the maturity level of the newborns and the risk of acquiring MDR bacterial colonization or infection [3,20,[26][27][28]32]. Haase et al (2014) detected low gestational age and need for mechanical ventilation as risk factors for colonization with MDR bacteria [20], Sakai et al (2020) found an association with prematurity, extremely low birth weight, and non-exclusive breastfeeding [32].…”

“…In contrast to the results of other studies, we did not find any association of the maturity level of the newborns and the risk of acquiring MDR bacterial colonization or infection [3,20,[26][27][28]32]. Haase et al (2014) detected low gestational age and need for mechanical ventilation as risk factors for colonization with MDR bacteria [20], Sakai et al (2020) found an association with prematurity, extremely low birth weight, and non-exclusive breastfeeding [32]. Auriti et al (2003) found a higher risk of contracting hospital acquired infections for infants with a very low birth weight, low gestational age and intravascular catheters [3].…”

“…One explanation for this difference might be the higher likelihood of antibiotic use for mothers that undergo cesarean section [31]. However other studies did not show this correlation [20,28,32]. However, Smith et al (2010) reported an association between vaginal delivery and bloodstream infection with GNB [14].…”

High Virulence and Multidrug Resistance of Escherichia coli Isolated in Periodontal Disease

“…The American Type Culture Collection (ATCC) strain E. coli 25922 was used as the control. Strains resistant to more than three antibiotics belonging to different categories were classified as multidrug-resistant (MDR) [ 27 ].…”

Bacteriological profile and antimicrobial susceptibility pattern of endotracheal tube secretion of patients in ICUs of a tertiary care hospital in Punjab

“…12 Studies highlighted that frequent and unselective usage of broad spectrum antibiotics without consideration of culture and Susceptibility reporting leads to the development of multidrug resistant microorganisms (MDRs). 13 These MDRs are frequently colonized through endogenous or exogenous sources on life saving instruments such as Mechanical Ventilators in ICUs. 14 Bacteriological examination of respiratory secretions offer helping hand to clinician in diagnosing VAP and also helps him to initiate early antibiotic regimen.…”