The mother as most important risk factor for colonization of very low birth weight (VLBW) infants with extended-spectrum  -lactamase-producing Enterobacteriaceae (ESBL-E)

Denkel, Luisa A.; Schwab, Frank J.; Kola, Axel; Leistner, Rasmus; Garten, Lars; Weizsäcker, Katharina; Geffers, Christine; Gastmeier, Petra; Piening, Brar

doi:10.1093/jac/dku097

Cited by 87 publications

(91 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results suggest an increase in the prevalence of colonization, consistent with the worldwide increase of ESBL-PE carriage in the community (18). Data on ESBL-PE colonization rates in LICs are scarce, especially among pregnant women, despite a risk of transmission from mothers to neonates (19)(20)(21). The isolation of an NDM-1-producing K. pneumoniae, the first NDM-1-PE identified in Madagascar, is of great concern.…”

supporting

confidence: 81%

Colonization of Extended-Spectrum-β-Lactamase- and NDM-1-Producing Enterobacteriaceae among Pregnant Women in the Community in a Low-Income Country: a Potential Reservoir for Transmission of Multiresistant Enterobacteriaceae to Neonates

Chéreau

Herindrainy

Garin

et al. 2015

Antimicrob Agents Chemother

View full text Add to dashboard Cite

The spread of extended-spectrum-␤-lactamase-producing Enterobacteriaceae (ESBL-PE) in low-income countries, where the burden of neonatal sepsis is high, may have a serious impact on neonatal mortality rates. Given the potential for mother-to-child transmission of multiresistant bacteria, this study investigated the ESBL-PE rectal colonization among pregnant women at delivery in the community in Madagascar and estimated a prevalence of 18.5% (95% confidence interval, 14.5% to 22.6%). One strain of Klebsiella pneumoniae isolated was also a New Delhi metallo-␤-lactamase-1 (NDM-1) producer. Severe bacterial infections are responsible for a large number of neonatal deaths in low-income countries (LICs) (1, 2), with Enterobacteriaceae most frequently isolated in neonatal sepsis (3,4). The production of plasmid-borne extended-spectrum ␤-lactamases (ESBL) is the main mechanism of resistance against expanded-spectrum cephalosporins (ESC) among Enterobacteriaceae, with the CTX-M-15 variant being the most common enzyme (5). In LICs, where neonatal sepsis caused by ESBL-producing Enterobacteriaceae (ESBL-PE) may be associated with higher fatality rates (6), colonized mothers could represent a source of transmission to neonates. The objectives of this study were to estimate the prevalence of ESBL-PE rectal colonization among pregnant women in Madagascar in an urban area, Antananarivo, and a semirural area, Moramanga, and to identify associated risk factors.This study was conducted in the context of an international pediatric cohort, the BIRDY (bacterial infections and antibiotic resistance disease among young children in low-income countries) program, approved by the Ethics Committees of Ministry of Health, Madagascar, and Institut Pasteur, France. All pregnant women living in the study areas were identified by medical or community workers and enrolled after giving written informed consent. A stool sample was taken at delivery for ESBL-PE screening. Among the women enrolled, 356 gave birth between June 2013 and March 2014 and were included in the present study. A risk factor analysis was conducted on a subset of 231 women who delivered during a 6-month period (June to September 2013 and January to March 2014). Sociodemographic characteristics, previous health care exposure, and antibiotic consumption (collected with prescription documents, remaining tablets, or visual aid) were recorded. Fresh stools were plated onto Drigalski agar supplemented with 3 mg/liter of ceftriaxone at the clinical laboratory of Institut Pasteur of Madagascar. Plates were incubated for 24 to 48 h at 37°C. Every oxidase and Gram-negative colony type was Citation Chereau F, Herindrainy P, Garin B, Huynh B-T, Randrianirina F, Padget M, Piola P, Guillemot D, Delarocque-Astagneau E. 2015. Colonization of extendedspectrum-␤-lactamase-and NDM-1-producing Enterobacteriaceae among pregnant women in the community in a low-income country: a potential reservoir for transmission of multiresistant Enterobacteriaceae to neonates.

show abstract

supporting

confidence: 81%

Colonization of Extended-Spectrum-β-Lactamase- and NDM-1-Producing Enterobacteriaceae among Pregnant Women in the Community in a Low-Income Country: a Potential Reservoir for Transmission of Multiresistant Enterobacteriaceae to Neonates

Chéreau

Herindrainy

Garin

et al. 2015

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…There have been reports on the risk factors for infection or colonization by ESBL-producing bacteria in children from pediatric intensive care units and neonatal intensive care units; the risk factors identified include artificial nails of hospital staff, cockroach infestation as vectors [40,41], younger gestational age, low birth weight, prolonged mechanical ventilation, longer hospital stay, invasive devices, antibiotic use [42][43][44][45], and mother-to-child transmission [46].…”

Section: Discussionmentioning

confidence: 99%

Multidrug-resistant ESBL-producing Enterobacteriaceae and associated risk factors in community infants in Lebanon

Hijazi

Fawzi

Ali

et al. 2016

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) infections are a growing threat to children, and the treatment of these infections becomes more and more challenging. A huge reservoir for ESBLs in the community is the fecal flora of children. This study investigates the rectal colonization, associated risk factors, antimicrobial susceptibility, and molecular characterization of ESBL-PE in Lebanese community infants. Methodology: A total of 117 rectal swabs were taken from healthy infants between 1 and 12 months of age. Detection of ESBLs was carried out using the double-disk synergy test, combination-disk method, and multiplex polymerase chain reaction (PCR). A questionnaire about the infant's history and risk factors for carrying ESBL-PE was administered. Results: In total, 58 (49.6%) of 117 participants were ESBL-PE carriers. Some significant important risk factors for colonization in this study were male gender, hospital birth, caesarean delivery, and being formula-fed. Observed decrease in colonization rate was associated with intimate hygiene habits. Carriers of multiple bla genes were the most common. CTX-M type was the major harbored, gene and CTX-M-9 was the most predominant, followed by CTX-M-15 type. Conclusions: To the best of our knowledge, this is the first available data about the carriage rate of ESBL-PE in community infants in Lebanon and the Middle East, the first study showing that birth in hospital, caesarean delivery, and being formula-fed are all significantly associated risk factors for the high colonization rates in community -not hospitalized -infants, and showing the dominance of multiple resistance gene carriage and wide dissemination of CTX-M-9 ESBL.

show abstract

“…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

View full text Add to dashboard Cite

show abstract

The mother as most important risk factor for colonization of very low birth weight (VLBW) infants with extended-spectrum -lactamase-producing Enterobacteriaceae (ESBL-E)

Cited by 87 publications

References 42 publications

Colonization of Extended-Spectrum-β-Lactamase- and NDM-1-Producing Enterobacteriaceae among Pregnant Women in the Community in a Low-Income Country: a Potential Reservoir for Transmission of Multiresistant Enterobacteriaceae to Neonates

Colonization of Extended-Spectrum-β-Lactamase- and NDM-1-Producing Enterobacteriaceae among Pregnant Women in the Community in a Low-Income Country: a Potential Reservoir for Transmission of Multiresistant Enterobacteriaceae to Neonates

Multidrug-resistant ESBL-producing Enterobacteriaceae and associated risk factors in community infants in Lebanon

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

Contact Info

Product

Resources

About