Bavarian Health and Food Safety Authority, Munich/Oberschleißheim/Erlangen, Germany.
Bavarian State Ministry of Public Health and Care Services, Munich, Germany.
J Matern Fetal Neonatal Med. 2022 Nov;35(22):4243-4249. doi: 10.1080/14767058.2020.1849100. Epub 2020 Nov 18.
The prevalence of antimicrobial-resistant bacteria and methicillin-sensitive (MSSA) in healthy newborns and the role of maternal transmission are scarcely discussed.
The objective of this study was to evaluate the prevalence of MSSA, MRSA, and ESBL among healthy newborns. Additionally, mother-to-newborn transmission rates were investigated as well as antibiotic susceptibility of MSSA, MRSA, and ESBL isolates.
Swabs of 658 newborns and their mothers were collected to investigate the presence of MSSA, MRSA, and ESBL. Swabs were taken from the nose and umbilicus immediately after birth. Additional swabs were taken from the nose, perianal area, and umbilicus 3 days after birth. Samples were screened and further characterized using culture and molecular methods.
Prevalence of MSSA, MRSA, and ESBL colonization was 10.9, 0.5, and 2.6%, respectively. There was no association between the colonization status of the newborn and infections at any time point. Mother-to-newborn transmission rates (confirmed by PFGE) were 53.6% for MSSA/MRSA and 100% for ESBL. Maternal carriage of MSSA, MRSA, or ESBL was a risk factor for colonization of the newborn. Some isolates were resistant to the antibiotics recommended for therapy, including clindamycin and daptomycin for MSSA/MRSA isolates and ertapenem, fosfomycin, and tigecyclin for ESBL isolates.
No association between infections and the newborns' colonization status could be detected. Maternal colonization played an important role in newborn colonization, but not every case of colonization could be explained by mother-to-newborn transmission. General screening of pregnant women and healthy newborns in the absence of other risk factors is not necessary. To prevent the possibility of transmission in the healthcare setting, professionals, pregnant women, parents, hospital visitors, and obstetricians should receive regular training on appropriate hygiene measures. With regard to the emergence of resistance to recommended antibiotics, an antibiogram should be conducted before treating MSSA/MRSA/ESBL infections to ensure the efficacy of the antibiotics.
健康新生儿中抗菌药物耐药菌和甲氧西林敏感金黄色葡萄球菌（MSSA）的流行情况以及母婴传播的作用鲜有讨论。
本研究旨在评估健康新生儿中 MSSA、MRSA 和 ESBL 的流行情况。此外，还调查了母婴传播率以及 MSSA、MRSA 和 ESBL 分离株的抗生素药敏情况。
采集 658 例新生儿及其母亲的拭子，以调查 MSSA、MRSA 和 ESBL 的存在情况。新生儿出生后立即从鼻子和脐部采集拭子。出生后第 3 天，从鼻子、肛周和脐部再次采集拭子。采用培养和分子方法进行筛查和进一步鉴定。
MSSA、MRSA 和 ESBL 定植率分别为 10.9%、0.5%和 2.6%。新生儿定植状态与任何时间点的感染均无关联。经 PFGE 证实的 MSSA/MRSA 母婴传播率为 53.6%，ESBL 为 100%。母亲携带 MSSA、MRSA 或 ESBL 是新生儿定植的危险因素。一些分离株对推荐用于治疗的抗生素具有耐药性，包括 MSSA/MRSA 分离株的克林霉素和达托霉素，以及 ESBL 分离株的厄他培南、磷霉素和替加环素。
未发现感染与新生儿定植状态之间存在关联。母亲定植在新生儿定植中发挥了重要作用，但并非所有定植病例都可以用母婴传播来解释。在不存在其他危险因素的情况下，对孕妇和健康新生儿进行常规筛查是没有必要的。为了防止在医疗保健环境中传播的可能性，应定期对专业人员、孕妇、家长、医院访客和产科医生进行适当卫生措施的培训。鉴于对推荐抗生素的耐药性出现，在治疗 MSSA/MRSA/ESBL 感染之前，应进行药敏试验，以确保抗生素的疗效。
