Vaginal colonization of extended-spectrum beta-lactamase-producing bacteria during pregnancy: An observational study

Foessleitner, Philipp; Gasser, Julia; Kiss, Herbert; Flunt, A; Presterl, Elisabeth; Petricevic, Ljubomir; Farr, Alex

doi:10.1016/j.ejogrb.2020.01.025

Cited by 13 publications

(25 citation statements)

References 27 publications

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“…However, as the body of literature is relatively limited, this should be confirmed by cohort studies in women with an increased risk of infection. Women who are HIV‐positive have an increased risk of obstetric complications, including PTB, 4‐6 which is a multifactorial event that is frequently caused by an overgrowth of anaerobic bacteria in the vaginal microbiota 10‐14,30 . Of note, the risk of PTB was not increased in the cases of our study, which might be because infections were consequently treated and follow‐up smears were performed.…”

Section: Discussionmentioning

confidence: 61%

“…Imbalances in the vaginal ecosystem can lead to PTB, 10‐14 which is the main cause of neonatal morbidity and mortality worldwide. In our study, we found that HIV‐positive women had an increased risk of developing dysbiosis, BV, and VVC during pregnancy, when being compared to the controls.…”

Section: Discussionmentioning

confidence: 99%

“…In pregnant women, vaginal dysbiosis, and BV in particular, represents causative factors in the multifactorial event of PTB 10‐14 . In addition to the association between BV and PTB, 15‐17 certain groups have an increased risk of vaginal infections, which underlines the importance of screening women for vaginal dysbiosis and for colonization by potentially harmful pathogens, in order to prevent them from ascending and causing preterm contractions, cervical insufficiency, and PTB 11,18,19 .…”

Section: Introductionmentioning

confidence: 99%

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HIV infection as a risk factor for vaginal dysbiosis, bacterial vaginosis, and candidosis in pregnancy: A matched case‐control study

Foessleitner

Petricevic

Boerger

et al. 2021

Birth

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Background This study aimed to evaluate the vaginal microbiota of HIV‐positive pregnant women relative to HIV‐negative controls, and to compare their risk of vaginal dysbiosis, bacterial vaginosis, and vulvovaginal candidosis (VVC). Methods This is a nested matched case‐control study that analyzed data from women who received pregnancy care at our center from 2003 to 2014. Women routinely underwent screening for asymptomatic vaginal infections using phase microscopy on Gram‐stained smears. HIV‐positive women were assigned to the case group, and HIV‐negative women were assigned to the control group. Cases and controls were matched in a 1:4 ratio. Logistic regression was used to test whether HIV infection was associated with vaginal dysbiosis (Nugent score 4‐6), BV (Nugent score 7‐10), or VVC. Results One hundred and twenty‐seven women were assigned to the case group, and 4290 were assigned to the control group (including 508 matched controls). Dysbiosis or BV was found in 29.9% of the cases and 17.6% of the controls. Women in the case group had increased risk of vaginal dysbiosis or BV (odds ratio [OR] 2.09, 95% confidence interval [CI], 1.30‐3.32, P = .002). The risk of VVC was also higher in the case group (OR 2.14, 95% CI, 1.22‐3.77, P = .008). The incidence of preterm birth did not differ significantly between the groups (cases: 8.7%; controls: 10%, P = .887). Conclusions HIV‐positive women are at risk of vaginal dysbiosis, BV, and VVC during pregnancy. As imbalances of the vaginal microbiota can lead to preterm birth, screening and treatment of HIV‐positive pregnant women are warranted.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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HIV infection as a risk factor for vaginal dysbiosis, bacterial vaginosis, and candidosis in pregnancy: A matched case‐control study

Foessleitner

Petricevic

Boerger

et al. 2021

Birth

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“…Maternal colonization of ARB was identified as a risk factor for colonization in the newborn [2,3,[17][18][19][20]. Therefore, studying the prevalence of ARB among pregnant women is very important.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, studying the prevalence of ARB among pregnant women is very important. Various ESBL colonization rates among pregnant mothers in different countries were reported [3,[15][16][17]19,20]. Similarly, the rates of maternal MRSA colonization varied between different geographic areas.…”

Section: Introductionmentioning

confidence: 99%

Mother-to-Neonate Transmission of Antibiotic-Resistant Bacteria: A Cross-Sectional Study

et al. 2021

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We evaluated carriage rates of extended spectrum β-lactam-producing Enterobacterales (ESBL-E), Carbapeneme-resistant Enterobacterales (CRE), vancomycin-resistant Enterococci (VRE), and methicillin-resistant Staphylococcus aureus (MRSA) among pregnant women and determined the maternal-to-neonate transmission rates of these antibiotic-resistant bacteria (ARB). Pregnant women provided rectal and vaginal samples, proximal to delivery. Stool samples were collected from newborns within 48 h of birth. All samples were cultured on selective media for ARB identification. Clinical and demographic data were collected from the participants’ medical files. We performed molecular and phenotypic characterization of the different resistance mechanisms, and determined the isolates’ antibiotic susceptibility and biofilm-forming ability. The prevalence of ESBL-E, MRSA and VRE among pregnant women were 16%, 6% and 1%, respectively. The prevalence of ESBL-E and MRSA among neonates were 7.6% and 1.6%, respectively. Maternal-to-neonate transmission rates of ESBL-E and MRSA were 48% and 27.8%, respectively. Maternal and neonatal isolates shared similar characteristics. Maternal-to-neonate transmission of ARB plays an important role in bacterial colonization in newborns. Future studies should investigate the outcomes of the high ESBL-E transmission rate. The biofilm-forming ability of ARB was found to affect transmission. Additional factors should be investigated in order to understand the differences between transmitted and non-transmitted bacteria.

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Maternal colonization with extended‐spectrum β‐lactamase‐producing Enterobacteriaceae in term versus preterm pregnancies

Sgayer

Glikman

Shqara

et al. 2022

Intl J Gynecology & Obste

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Enterobacteriaceae that produce extended-spectrum β-lactamases (ESBL-E) carry plasmid-encoded enzymes that can efficiently hydrolyze and confer resistance to a variety of β-lactam antibiotics. These enzymes are predominantly found in Escherichia coli and Klebsiella pneumoniae, although they present in other members of Enterobacteriaceae as well. 1 Maternal ESBL-E colonization has been reported worldwide with different geographic distributions. 2,3 Risk factors for colonization or

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Vaginal colonization of extended-spectrum beta-lactamase-producing bacteria during pregnancy: An observational study

Cited by 13 publications

References 27 publications

HIV infection as a risk factor for vaginal dysbiosis, bacterial vaginosis, and candidosis in pregnancy: A matched case‐control study

HIV infection as a risk factor for vaginal dysbiosis, bacterial vaginosis, and candidosis in pregnancy: A matched case‐control study

Mother-to-Neonate Transmission of Antibiotic-Resistant Bacteria: A Cross-Sectional Study

Maternal colonization with extended‐spectrum β‐lactamase‐producing Enterobacteriaceae in term versus preterm pregnancies

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