Maternal colonization with extended-spectrum β-lactamase-producing Enterobacteriaceae in term versus preterm pregnancies.

OBJECTIVES

To examine the prevalence and risk factors of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) colonization among women who delivered preterm and at term.

METHODS

A prospective observational study of maternal ESBL-E rectovaginal colonization in threatened preterm labor and low-risk term pregnancies was conducted between March 2017 and August 2021 at the Galilee Medical Center, Israel. Obstetric and neonatal complications were compared between colonized and non-colonized mothers and neonates.

RESULTS

ESBL-E colonization was similar in the preterm (n = 202) and term (n = 172) groups: 14.4% and 16.9%, respectively (P = 0.567). The maternal-neonatal transmission rate was higher in the preterm than the term group but the difference was not statistically significant: 42.1% and 22.2%, respectively (P = 0.42). Prematurity was a risk factor of neonatal ESBL-E colonization (odds ratio 1.33, 95% confidence interval 1.01-1.75, P = 0.041). ESBL-E-colonized preterm infants were delivered at an earlier gestational age and were more likely to have complications. Maternal ESBL-E colonization and transmission were more prevalent in pregnancies complicated by threatened preterm labor or premature rupture of membranes than in term pregnancies.

CONCLUSIONS

These findings emphasize the need for further research on the cost-effectiveness of screening for maternal ESBL-E colonization in preterm labor, to prevent neonatal infectious complications.

CLINICALTRIALS

gov identifier NCT03251885.