Department of Neonatology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Medicina (Kaunas). 2012;48(2):71-6. Epub 2012 Apr 5.
Escherichia coli is one of the leading causes of early-onset neonatal sepsis in many industrialized countries. However, there is a lack of studies on Escherichia coli colonization in women and neonates. The study aimed at determining the prevalence Escherichia coli among pregnant women and newborns, perinatal transmission, antimicrobial susceptibility, and risk factors for neonatal colonization.
In this prospective, cross-sectional study, 827 infants born to 808 mothers were enrolled. The study was carried out from October 1, 2006, to June 30, 2007. Women were screened for E. coli carriage at 35-37 weeks of gestation or on admission for premature rupture of membranes and delivery; neonates, within 15 minutes of their lives. Risk factors for colonization were collected by a questionnaire and were recorded during labor.
Maternal E. coli colonization rate was 19.9%; neonatal, 14.4%; and transmission rate, 21.4%. Less than one-fourth (22.7%) of neonatal E. coli strains were resistant to ampicillin. Logistic regression analysis revealed that anal sexual intercourse (OR, 3.91; 95% CI, 1.87-8.19), one sexual partner (OR, 2.01; 95% CI, 1.30-3.11), maternal vaginal Escherichia coli colonization (OR, 1.81; 95% CI, 1.12-2.93), maternal body mass index of ≤27 (OR, 1.77; 95% CI, 1.15-2.73), and maternal education lower than university level (OR, 1.70; 95% CI, 1.06-2.74) were associated with neonatal Escherichia coli colonization.
The prevalence of maternal Escherichia coli colonization was higher in this study than other studies (19.9%). Neonatal Escherichia coli colonization was 14.4%. The resistance of Escherichia coli isolates to ampicillin was not high (22.7%). Improvement of maternal education and modification of mothers' sexual habits need to be undertaken to prevent neonatal Escherichia coli colonization.
本研究旨在确定孕妇和新生儿中大肠杆菌的流行率、围产期传播、抗菌药物敏感性以及新生儿定植的危险因素。
在这项前瞻性、横断面研究中，共纳入了 808 名产妇所分娩的 827 例婴儿。研究于 2006 年 10 月 1 日至 2007 年 6 月 30 日进行。在妊娠 35-37 周或胎膜早破及分娩时，对产妇进行大肠杆菌携带筛查；在出生后 15 分钟内，对新生儿进行筛查。通过问卷调查收集定植的危险因素，并在分娩期间记录。
产妇大肠杆菌定植率为 19.9%；新生儿为 14.4%；传播率为 21.4%。不到四分之一（22.7%）的新生儿大肠杆菌菌株对氨苄西林耐药。logistic 回归分析显示，肛交（OR=3.91；95%CI，1.87-8.19）、单一性伴侣（OR=2.01；95%CI，1.30-3.11）、产妇阴道大肠杆菌定植（OR=1.81；95%CI，1.12-2.93）、产妇 BMI 不超过 27（OR=1.77；95%CI，1.15-2.73）和产妇受教育程度低于大学水平（OR=1.70；95%CI，1.06-2.74）与新生儿大肠杆菌定植相关。
与其他研究相比，本研究中产妇大肠杆菌定植率较高（19.9%）。新生儿大肠杆菌定植率为 14.4%。大肠杆菌分离株对氨苄西林的耐药率不高（22.7%）。需要提高产妇教育水平，改变产妇的性行为习惯，以预防新生儿大肠杆菌定植。
