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Clinical relevance of colonization with antimicrobial-resistant bacteria (AMRB) and methicillin susceptible Staphylococcus aureus (MSSA) for mothers during pregnancy

  • General Gynecology
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Abstract

Purpose

The impact of colonization with antimicrobial-resistant bacteria (AMRB) and methicillin-sensitive Staphylococcus aureus (MSSA) of healthy pregnant women is not described in detail in Germany. In this study, we screened for MSSA and AMRB, especially for methicillin-resistant S. aureus (MRSA) as well as extended-spectrum beta-lactamase (ESBL)-producing E. coli. Potential risk factors for colonization with AMRB/MSSA and the potential effects of colonization with these on the obstetric population were investigated.

Methods

From October 2013 until December 2015 pregnant women were screened before birth for colonization with AMRB/MSSA from the mammillae, nose, perianal and vaginal area. Before birth, the expectant mother was administered a standardized interview questionnaire by a trained interviewer. Data from the hospital admission records were also included.

Results

Samples from 651 pregnant women were analyzed. Colonization with MSSA was detected in 14.3% (n = 93), AMRB in 3.5% [(n = 23); MRSA: n = 3/ESBL: n = 20]. Significantly more colonization of AMRB/MSSA could be detected in women who had previously given birth compared to women who were nulliparous (p < 0.05). MSSA colonization was significantly associated with self-reported respiratory diseases during pregnancy (p < 0.05), but AMRB/MSSA colonization was not statistically associated with other types of infection.

Conclusion

Our results demonstrate a low overall rate of colonization with AMRB/MSSA, as well as a low percentage of colonized pregnant women who developed infections. Multiparous women are at higher risk for colonization with MSSA/MRSA or ESBL. Because the prevalence of AMRB/MSSA is low, this study suggests that general screening of pregnant women without risk factors is not recommended.

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Funding

This study was funded by the Bavarian State Ministry of Public Health and Care Services.

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Authors and Affiliations

  1. Bavarian Health and Food Safety Authority, Munich/Oberschleißheim/Erlangen, Germany

    A. H. Dammeyer, S. Heinze, L. Schomacher, M. Zamfir, K. Heigl, S. Hörmansdorfer, C. Tuschak, G. Valenza & C. Herr

  2. Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Clinic of the University of Munich, Munich, Germany

    S. Heinze, U. Ochmann & C. Herr

  3. Bavarian State Ministry of Public Health and Care Services, Munich, Germany

    A. C. Adler

  4. Klinikum Augsburg, Women’s Clinic, Augsburg, Germany

    L. Nasri & M. Franitza

  5. Rotkreuzklinikum München, Women’s Clinic, Munich, Germany

    B. Karlin

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  1. A. H. Dammeyer
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  2. S. Heinze
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Contributions

AHD: Data Collection, Data Analysis, Manuscript writing. SH: Protocol/project development, Manuscript editing. ACA: Protocol/project development, Laboratory work, Data Collection, Manuscript editing. LN: Data Collection, Protocol development. LS: Data Collection, Protocol development. MZ: Data Collection, Data Analysis, Laboratory work, Manuscript editing. KH: Manuscript editing. BK: Protocol/project development, Data Collection. MF: Protocol/project development, Data Collection. SH: Laboratory work. CT: Laboratory work. GV: Laboratory work. UO: Protocol/project development. CH: Protocol/project development, Manuscript editing.

Corresponding author

Correspondence to A. H. Dammeyer.

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Ethical approval was provided by the Ludwig-Maximilians-University, Munich, Germany. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Dammeyer, A.H., Heinze, S., Adler, A.C. et al. Clinical relevance of colonization with antimicrobial-resistant bacteria (AMRB) and methicillin susceptible Staphylococcus aureus (MSSA) for mothers during pregnancy. Arch Gynecol Obstet 300, 1303–1316 (2019). https://doi.org/10.1007/s00404-019-05287-6

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