Staphylococcus Infections in Pregnancy

Kriebs, Jan M.

doi:10.1097/jpn.0000000000000165

Cited by 15 publications

(10 citation statements)

References 62 publications

(71 reference statements)

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“…Given that MRSA is generally found in the epidermis, we think this is a plausible observation and consistent with other reports 7,17 . MRSA was the causative bacterium in the neonates delivered by the three mothers who were MRSA carriers (Table 4).…”

Section: Discussionsupporting

confidence: 93%

Vertical transmission of methicillin-resistant Staphylococcus aureus at delivery and its clinical impact: an observational, prospective cohort study

Ogura

Inayama

Sasamoto

et al. 2021

Preprint

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Objectives: To accurately assess the vertical transmission rate of Methicillin-resistant Staphylococcus aureus (MRSA) and its clinical impacts on pregnant mothers and neonates. Design: A prospective observational cohort study. Setting: Japan. Population: 898 pregnant women and their 905 neonates delivered in gestation week > 32+0 at Toyooka Hospital from August 2016 to December 2017. Methods: MRSA was cultured from the nasal and vaginal samples taken from mothers at enrollment and the nasal and umbilical samples taken from neonates immediately after their birth. We examined the vertical transmission rate of MRSA in mother-neonate pairs. We used multivariable logistic regression to identify maternal/neonatal adverse outcomes associated with maternal MRSA colonization. Main outcome measures: The frequency of maternal/neonatal MRSA colonization and adverse outcomes. Results: The prevalence of maternal MRSA colonization was 6.1% (55/898), and that of neonates was 0.8% (8/905). The prevalence of neonatal MRSA was 12.7% (7/55 mother-neonate pairs) in the MRSA-positive mothers, whereas it was only 0.12% (1/843 pairs) in the MRSA-negative mothers (OR: 121, 95% CI: 14.6-1000). When the maternal vaginal-MRSA was positive, the vertical transmission rate was 44.4% (4/9). Skin and soft tissue infections (SSTIs) developed significantly more frequently in neonates born to the MRSA-positive mothers (OR: 7.47, 95% CI: 2.50-22.3). Conclusions: The prevalence of MRSA in pregnant women was approximately 6%. The vertical transmission rate of vaginal MRSA was as high as 44.4%. Maternal MRSA colonization is associated with increased development of neonatal SSTIs via vertical transmission.

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Section: Discussionsupporting

confidence: 93%

Vertical transmission of methicillin-resistant Staphylococcus aureus at delivery and its clinical impact: an observational, prospective cohort study

Ogura

Inayama

Sasamoto

et al. 2021

Preprint

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“…The high rate of vertical transmission found in our study differs from the results of previous studies that reported the vertical transmission of MRSA from mothers to their neonates. 16,18,21,23,24,25 In these reports, the vertical transmission rate of MRSA was as high as 10%, and no study reported a rate as high as the 40% observed in this study. This inconsistent observation may in part be due to the small sample size in our study, in which only nine pregnant women had MRSA detected in the vagina.…”

Section: Discussionmentioning

confidence: 58%

Vertical transmission of methicillin‐resistant Staphylococcus aureus at delivery and its clinical impact: An observational, prospective cohort study

Ogura

Inayama

Sasamoto

et al. 2021

Acta Obstet Gynecol Scand

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IntroductionMethicillin‐resistant Staphylococcus aureus (MRSA) infection has a significant clinical impact on both pregnant women and neonates. The aim of this study was to assess accurately the vertical transmission rate of MRSA and its clinical impacts on both pregnant mothers and neonates.Material and methodsWe conducted a prospective observational cohort study of 898 pregnant women who were admitted to our department and 905 neonates from August 2016 to December 2017. MRSA was cultured from nasal and vaginal samples taken from the mothers at enrollment and from nasal and umbilical surface swabs taken from neonates at the time of delivery. We examined the vertical transmission rate of MRSA in mother‐neonate pairs. We used multivariable logistic regression to identify risk factors for maternal MRSA colonization and maternal/neonatal adverse outcomes associated with maternal MRSA colonization.ResultsThe prevalence of maternal MRSA colonization was 6.1% (55 of 898) at enrollment. The independent risk factors were multiparity and occupation (healthcare provider) (odds ratio [OR] 2.35, 95% confidence interval [CI] 1.25–4.42 and OR 2.58, 95% CI 1.39–4.79, respectively). The prevalence of neonatal MRSA colonization at birth was 12.7% (7 of 55 mother‐neonate pairs) in the maternal MRSA‐positive group, whereas it was only 0.12% (one of 843 pairs) in the maternal MRSA‐negative group (OR 121, 95% CI 14.6–1000). When maternal vaginal samples were MRSA‐positive, vertical transmission was observed in four of nine cases (44.4%) in this study. Skin and soft tissue infections developed more frequently in neonates in the maternal MRSA‐positive group than in the MRSA‐negative group (OR 7.47, 95% CI 2.50–22.3).ConclusionsThe prevalence of MRSA in pregnant women was approximately 6%. Vertical transmission caused by maternal vaginal MRSA colonization was observed in four of nine cases (44.4%). Although our study includes a limited number of maternal MRSA positive cases, the vertical transmission of MRSA may occur in up to 44% of neonates of mothers with vaginal MRSA colonization. Maternal MRSA colonization may be associated with increased development of skin and soft tissue infections in neonates via vertical transmission.

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“…The abundance of antibiotic-resistant species varied greatly among samples and groups. Overall, the antibiotic-resistance abundance was higher in NP group samples, whereas samples from pregnant groups were abundantly inhabited by commensal opportunistic pathogens from the genera Enterococcus, Klebsiella, Streptococcus , and Staphylococcus 41,48,49. Moreover, all the tested (Antimicrobials) AMs confronted resistance.…”

Section: Discussionmentioning

confidence: 96%

<p>Evaluation of gut bacterial community composition and antimicrobial resistome in pregnant and non-pregnant women from Saudi population</p>

Khan¹,

Yasir²,

Farman³

et al. 2019

IDR

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Background: Gut microbiota (GM) has recently been described as a functional reservoir of antimicrobial resistant genes (ARGs). However, the ARG-carrying bacterial species in the human gut has been poorly studied. This study, for the first time, is reporting bacterial communities' composition and antimicrobial resistome in the stool samples of pregnant and non-pregnant (NP) Saudi females. Methods: Gut bacterial community composition was analyzed by 16S amplicon sequencing and culturomics. High throughput MALDI-TOF technique was used for identification of the isolates from stool samples and evaluated for resistance against 13 antibiotics using the agar dilution method. Clinically important ARGs were PCR amplified from genomic DNA of the stool samples using gene-specific primers. Results: 16S amplicon sequencing revealed that GM of pregnant and NP women were predominantly comprised of phyla Firmicutes, Bacteroidetes, Proteobacteria, and Actinobacteria. Bacterial diversity decreased in pregnant groups, whereas phylum Bacteroidetes declined significantly ( p <0.05) in the first trimester. We noticed a relatively high abundance of butyrate-producing bacteria (eg, Faecalibacterium spp. and Eubacterium spp.) in the gut of pregnant women, whereas Prevotella copri was found at significantly ( p <0.01) higher abundance in NP women. Moreover, about 14,694 isolates were identified and classified into 132 distinct species. The majority of the species belonged to phyla Firmicutes and Proteobacteria. About 8,125 isolates exhibited resistance against antibiotics. Out of 73 resistant-species, Enterococcus was the most diverse genus and Escherichia coli was the highly prevalent bacterium. The majority of the isolates were resistant to antibiotics; trimethoprim/sulfamethoxazole, cycloserine, and cefixime. ARGs encoding resistance against aminoglycoside, macrolide, quinolone, β-lactam, and tetracycline antibiotics were predominantly found in genomic DNA of the stool samples. Conclusion: We conclude that pregnancy-associated GM modulations may help to sustain a healthy pregnancy, but a higher proportion of antibiotic resistance could be deleterious for both maternal and fetal health.

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Staphylococcus Infections in Pregnancy

Cited by 15 publications

References 62 publications

Vertical transmission of methicillin-resistant Staphylococcus aureus at delivery and its clinical impact: an observational, prospective cohort study

Vertical transmission of methicillin-resistant Staphylococcus aureus at delivery and its clinical impact: an observational, prospective cohort study

Vertical transmission of methicillin‐resistant Staphylococcus aureus at delivery and its clinical impact: An observational, prospective cohort study

<p>Evaluation of gut bacterial community composition and antimicrobial resistome in pregnant and non-pregnant women from Saudi population</p>

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