CTX-M-producing Escherichia coli in a maternity ward: a likely community importation and evidence of mother-to-neonate transmission

Dubois, Vivien; Barbeyrac, Bertille de; Rogues, Anne-Marie; Arpin, Corinne; Coulange, Laure; André, Catherine; M’Zali, Fatima; Mégraud, Françis; Quentin, Claudine

doi:10.1093/jac/dkq153

Cited by 40 publications

(25 citation statements)

References 10 publications

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“…Once blood and, in most clinical scenarios, CSF and/or urine samples are promptly obtained, the combination of ampicillin and gentamicin is still the most appropriate coverage for the most common organisms, GBS and E. coli, which still predominate as etiologic pathogens in this age group (11). There has, however, been an increased prevalence of community extended-spectrum beta-lactamase (ESBL) producers as etiologic agents of neonatal sepsis (216,217). ESBLs, found mostly in nosocomial E. coli and Klebsiella pneumoniae infections, are enzymes that confer resistance to beta-lactam antibiotics, including penicillins, cephalosporins, and the monobactam aztreonam (218,219).…”

Section: Empirical Antibiotic Therapymentioning

confidence: 99%

“…With the increase in the prevalence of community-acquired ESBL-producing E. coli infections, penicillins, cephalosporins, and aminoglycosides would become less useful empirical therapeutic options. In these ESBL-producing E. coli infections, meropenem has been used successfully in neonates (216,217,222,(237)(238)(239). For other Gram-negative organisms, the treatment duration is similar to that for E. coli, but the greater incidence of some complications of meningeal infections, such as brain abscess associated with Citrobacter, Enterobacter, and Serratia spp., may necessitate a longer treatment duration (240)(241)(242).…”

Section: Pathogen-directed Therapymentioning

confidence: 99%

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Early-Onset Neonatal Sepsis

et al. 2014

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SUMMARY Early-onset sepsis remains a common and serious problem for neonates, especially preterm infants. Group B streptococcus (GBS) is the most common etiologic agent, while Escherichia coli is the most common cause of mortality. Current efforts toward maternal intrapartum antimicrobial prophylaxis have significantly reduced the rates of GBS disease but have been associated with increased rates of Gram-negative infections, especially among very-low-birth-weight infants. The diagnosis of neonatal sepsis is based on a combination of clinical presentation; the use of nonspecific markers, including C-reactive protein and procalcitonin (where available); blood cultures; and the use of molecular methods, including PCR. Cytokines, including interleukin 6 (IL-6), interleukin 8 (IL-8), gamma interferon (IFN-γ), and tumor necrosis factor alpha (TNF-α), and cell surface antigens, including soluble intercellular adhesion molecule (sICAM) and CD64, are also being increasingly examined for use as nonspecific screening measures for neonatal sepsis. Viruses, in particular enteroviruses, parechoviruses, and herpes simplex virus (HSV), should be considered in the differential diagnosis. Empirical treatment should be based on local patterns of antimicrobial resistance but typically consists of the use of ampicillin and gentamicin, or ampicillin and cefotaxime if meningitis is suspected, until the etiologic agent has been identified. Current research is focused primarily on development of vaccines against GBS.

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Section: Empirical Antibiotic Therapymentioning

confidence: 99%

Section: Pathogen-directed Therapymentioning

confidence: 99%

Early-Onset Neonatal Sepsis

et al. 2014

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“…5 Colonized mothers may transmit ESBL-E to their infants at birth, but to what extent vertical transmission contributes to colonization or infection in the infant is not known. [6][7][8][9] The intestinal tract of infants colonized by ESBL-E may serve as a reservoir and represent a risk for maternity ward and more importantly NICU outbreaks if standard infection control precautions fail. 10,11 Knowledge of the colonization burden in pregnant women and the extent of maternal-neonatal transmission are important for preventive strategies, including active surveillance and isolation of colonized patients.…”

Section: Introductionmentioning

confidence: 99%

Extended-spectrum β-lactamase-producing Enterobacteriaceae among pregnant women in Norway: prevalence and maternal–neonatal transmission

et al. 2015

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“…Pyelonephritis frequently requires initial IV antibiotic therapy, with an extended antimicrobial course of 10-14 days. 46 Antimicrobial therapy should be tailored to susceptibility results when available. 45 Failure to respond promptly to antimicrobial treatment warrants investigation for a structural abnormality or urinary stone.…”

Section: Urinary Tract Infection (Uti)mentioning

confidence: 99%

Sepsis in Pregnancy

Sung

George

Porter

2011

Fet. Matern. Med. Rev.

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Sepsis is associated with high morbidity and mortality worldwide. Although, it is not the major reason for intensive care unit admissions during pregnancy, several physiological changes that occur during pregnancy limit the ability of the pregnant woman to compensate for the derangements produced by severe sepsis, often resulting in severe organ dysfunction. Moreover, there are several disorders peculiar to the pregnant state, including preeclampsia, placental abruption, amniotic fluid embolism and postpartum haemorrhage, all of which can produce potentially life-threatening organ failure and may be present concurrently with sepsis contributing to maternal mortality. Evidence-based guidelines advocate assessment and monitoring aimed at early recognition and treatment of sepsis. Early goal-directed therapy, adequate blood glucose control, and corticosteroid replacement when indicated are improving outcomes in patients with severe sepsis, although most of these have not been validated in pregnancy.

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CTX-M-producing Escherichia coli in a maternity ward: a likely community importation and evidence of mother-to-neonate transmission

Cited by 40 publications

References 10 publications

Early-Onset Neonatal Sepsis

Early-Onset Neonatal Sepsis

Extended-spectrum β-lactamase-producing Enterobacteriaceae among pregnant women in Norway: prevalence and maternal–neonatal transmission

Sepsis in Pregnancy

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