Department of Infectious Diseases and LIM-54, University of São Paulo, 05403-900 São Paulo, Brazil.
Diagn Microbiol Infect Dis. 2012 Dec;74(4):343-8. doi: 10.1016/j.diagmicrobio.2012.08.006. Epub 2012 Sep 17.
The objective was to evaluate the performance of surveillance cultures at various body sites for Staphylococcus aureus colonization in pregnant women and newborns (NB) and the factors associated with nasal colonization. For NB, 4 sites were evaluated: nares, oropharynx, perineum, and umbilical stump (birth, third day, and weekly). For pregnant women, 4 sites during labor: anterior nares, anus, perineum, and oropharynx. Nasally colonized patients were compared with colonized only extranasally. Colonization was 53% of 392 pregnant women (methicillin-resistant S. aureus [MRSA]: 4%) and 47% of 382 NB (MRSA: 9%). For newborn patients, the best body site was the umbilical stump (methicillin-susceptible S. aureus [MSSA]: 64%; MRSA: 68%) and the combination of nares + umbilical (MSSA: 86%; MRSA: 91%). Among pregnant women, the best body site was the anterior nares (MSSA: 59%; MRSA: 67%) and the combination of nares + oropharynx (MSSA: 83%; MRSA: 80%). A smaller number of household members were associated with MRSA carriage in pregnant women (2.2 ± 0.6 versus 3.6 ± 1.8; P = 0.04). In conclusion, multiple culture sites are needed. Control programs based on surveillance cultures may be compromised.
目的是评估孕妇和新生儿（NB）不同身体部位金黄色葡萄球菌定植的监测培养表现，以及与鼻腔定植相关的因素。对于 NB，评估了 4 个部位：鼻腔、口咽、会阴和脐部残端（出生时、第 3 天和每周）。对于孕妇，在分娩期间评估了 4 个部位：前鼻腔、肛门、会阴和口咽。比较了鼻腔定植患者与仅鼻腔外定植患者。392 名孕妇中 53%定植（耐甲氧西林金黄色葡萄球菌 [MRSA]：4%），382 名 NB 中 47%定植（MRSA：9%）。对于新生儿患者，最佳的身体部位是脐部残端（甲氧西林敏感金黄色葡萄球菌 [MSSA]：64%；MRSA：68%）和鼻腔+脐部的组合（MSSA：86%；MRSA：91%）。对于孕妇，最佳的身体部位是前鼻腔（MSSA：59%；MRSA：67%）和鼻腔+口咽的组合（MSSA：83%；MRSA：80%）。孕妇中家庭成员较少与携带 MRSA 相关（2.2±0.6 与 3.6±1.8；P=0.04）。总之，需要多个培养部位。基于监测培养的控制计划可能会受到影响。
