Top Karina A, Buet Amanda, Whittier Susan, Ratner Adam J, Saiman Lisa
Departments of Pediatrics, and.
Pathology, Columbia University.
J Pediatric Infect Dis Soc. 2012 Mar;1(1):7-15. doi: 10.1093/jpids/pis001. Epub 2012 Mar 1.
Staphylococcus aureus infections are increasing among pregnant and postpartum women and neonates, but risk factors for S. aureus colonization in pregnancy and the association between maternal colonization and infant infections are not well defined. We sought to identify risk factors for maternal S. aureus rectovaginal colonization and assess colonization as a risk factor for infections among mothers and infants.
We conducted a retrospective cohort study of pregnant women and their infants. Demographic and clinical data, including S. aureus infections that occurred in mothers from 3 months before to 3 months after delivery and in infants during the first 3 months of life, were extracted from electronic medical records. Predictors for maternal S. aureus rectovaginal colonization were assessed through multivariable logistic regression analysis.
The cohort included 2702 women and 2789 infants. The prevalence of maternal rectovaginal colonization with methicillin-susceptible S. aureus and methicillin-resistant S. aureus (MRSA) was 13% and 0.7%. Independent predictors of colonization included multigravidity, human immunodeficiency virus seropositivity, and group B Streptococcus colonization. S. aureus colonization was associated with an increased risk of infection in mothers (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.4-8.8) but not in their infants (OR, 1.9; 95% CI, .6-5.6). The frequency of S. aureus infections was 0.8% in mothers and 0.7% in infants.
S. aureus rectovaginal colonization was associated with an increased risk of infections in women but not in their infants. The frequency of MRSA infections was low. These data suggest that routine MRSA screening of pregnant women may not be indicated.
金黄色葡萄球菌感染在孕妇、产后妇女和新生儿中呈上升趋势，但孕期金黄色葡萄球菌定植的危险因素以及母亲定植与婴儿感染之间的关联尚未明确界定。我们试图确定母亲金黄色葡萄球菌直肠阴道定植的危险因素，并评估定植作为母婴感染危险因素的情况。
我们对孕妇及其婴儿进行了一项回顾性队列研究。从电子病历中提取人口统计学和临床数据，包括母亲在分娩前3个月至分娩后3个月以及婴儿在出生后前3个月发生的金黄色葡萄球菌感染情况。通过多变量逻辑回归分析评估母亲金黄色葡萄球菌直肠阴道定植的预测因素。
该队列包括2702名妇女和2789名婴儿。对甲氧西林敏感金黄色葡萄球菌和耐甲氧西林金黄色葡萄球菌（MRSA）的母亲直肠阴道定植患病率分别为13%和0.7%。定植的独立预测因素包括多胎妊娠、人类免疫缺陷病毒血清阳性和B族链球菌定植。金黄色葡萄球菌定植与母亲感染风险增加相关（比值比[OR]，3.5；95%置信区间[CI]，1.4 - 8.8），但与婴儿感染风险增加无关（OR，1.9；95%CI，0.6 - 5.6）。母亲金黄色葡萄球菌感染发生率为0.8%，婴儿为0.7%。
金黄色葡萄球菌直肠阴道定植与女性感染风险增加相关，但与婴儿无关。MRSA感染发生率较低。这些数据表明，可能无需对孕妇进行常规MRSA筛查。
