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Evaluation of sampling locations in pregnant women and newborns for the detection of colonisation with antibiotic-resistant bacteria

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Abstract

Up to now, little has been known about the prevalence and clinical relevance of colonisation of asymptomatic pregnant women with methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA) or extended-spectrum β-lactamase (ESBL)-producing Escherichia coli. In this two-centre cross-sectional study, we evaluated the performance and importance of screening at different times and different locations for colonisation in pregnant women and newborns. Between October 2013 and December 2015, four samples were collected from pregnant women, two from newborns at birth and three from 3-day-old newborns. Samples were screened on culturing media and were confirmed with molecular methods. MSSA was used as a surrogate for MRSA, as the two share most microbiologic characteristics and colonisation patterns. Of 763 pregnant women, 14.5% (111) were colonised with MSSA, 0.4% (3) with MRSA and 2.6% (20) with ESBL-producing E. coli. Of 658 newborns, 0.9% (10) were colonised with MSSA at birth and 13.1% (70) at 3 days old, 0.5% (3) were colonised with MRSA and 2.6% (17) with ESBL-producing E. coli. Nasal sampling identified 91.0% of MSSA-colonised pregnant women and 60.0% of newborns. In newborns, nasal and umbilical sampling at 3 days after birth discovered 84.0% of colonised cases. For ESBL-producing E. coli, the perianal region was positive in all colonised pregnant women and in 88.2% of colonised newborns. Combining nasal and perianal swabs is optimal when screening for antibiotic-resistant bacteria in pregnant women. Nasal, perianal and umbilical sample collection from 3-day-old newborns significantly increased the sensitivity compared to screening immediately after birth.

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Authors and Affiliations

  1. Bavarian Health and Food Safety Authority, Pfarrstraße 3, 80538, Munich, Germany

    M. Zamfir, A. C. Adler, S. Kolb, A. Dammeyer, L. Schomacher, S. Hörmansdorfer, C. Tuschak, G. Valenza & C. Herr

  2. Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany

    M. Zamfir

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

    S. Kolb & U. Ochmann

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

    L. Nasri & M. Franitza

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

    B. Karlin

  6. University of Munich, Munich, Germany

    C. Herr

Authors
  1. M. Zamfir
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  2. A. C. Adler
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  3. S. Kolb
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  4. A. Dammeyer
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  6. L. Schomacher
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  7. B. Karlin
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  8. M. Franitza
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  9. S. Hörmansdorfer
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  10. C. Tuschak
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  11. G. Valenza
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  13. C. Herr
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Correspondence to M. Zamfir.

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Funding

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

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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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Informed consent was obtained from all individual participants included in the study.

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Zamfir, M., Adler, A.C., Kolb, S. et al. Evaluation of sampling locations in pregnant women and newborns for the detection of colonisation with antibiotic-resistant bacteria. Eur J Clin Microbiol Infect Dis 36, 1819–1826 (2017). https://doi.org/10.1007/s10096-017-2997-5

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  • DOI: https://doi.org/10.1007/s10096-017-2997-5

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