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耐甲氧西林金黄色葡萄球菌感染中垂直传播的潜在威胁:一项2022年的系统评价

The Potential Threat of Vertical Transmission in Methicillin-Resistant Staphylococcus Aureus Infection: A Systematic Review 2022.

作者信息

Allakky Akhil, Ferguson Asila A, Khan Aujala Irfan, Abuzainah Baraa, Gutlapalli Sai Dheeraj, Chaudhuri Dipabali, Khan Kokab Irfan, Al Shouli Roba, Khan Safeera

机构信息

Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

出版信息

Cureus. 2022 Dec 9;14(12):e32366. doi: 10.7759/cureus.32366. eCollection 2022 Dec.

Abstract

This systematic review paper aimed to assess and analyze the prevalence of maternal colonization of () also known as m () and m () in the peripartum period and its significance on vertical transmission to the neonate and if it is a potential threat to the health of newborns. For this, multiple databases, such as PubMed, MEDLINE, ScienceDirect, and the database of Elsevier, were used to scout for relevant articles, and results were reported adhering to the principles set by Preferred Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines 2020. A specific medical subject headings (MeSH) criterion was designed to search for relevant publications on PubMed. A total of 26 articles were finally selected after a meticulous screening process, including detailed inclusion and exclusion criteria, manual reading of titles and abstracts, and availability of accessible full-text articles. A few articles were also selected after going through the citations section of the initially selected papers. Quality appraisal was done on the selected publications. Maternal colonization of S. aureus is determined to be highly prevalent with the hypothesis that nasal colonization had higher rates than recto-vaginal sites. Increasing maternal age, history of vaginitis, and multiparity were the most common risk factors for and colonization. Premature babies were at the highest risk of colonization. Breast milk is also a risk factor for neonatal MRSA transmission. Through this systematic review, we concluded that although the rate of vertical transmission of MRSA is lower than that of MSSA, we felt that it held significance as neonates with the bug have poor outcomes due to skin and soft tissue infections and there is spread of MRSA to other neonates in the wards and spread to siblings in cases of triplets and quadruplets and even death due to potential MRSA sepsis. Women in Africa and China had high prevalence rates of MRSA and S. aureus which can probably be attributed to a lack of access to adequate healthcare facilities. We recommend screening with regular recto-vaginal swabs and nasal swabs especially in regions with a high burden of to be performed at regular intervals after confirmation of pregnancy, as prevention and screening are effective to avoid serious complications.

摘要

本系统评价论文旨在评估和分析围产期产妇金黄色葡萄球菌(也称为甲氧西林耐药金黄色葡萄球菌和甲氧西林敏感金黄色葡萄球菌)定植的患病率及其对新生儿垂直传播的意义,以及它是否对新生儿健康构成潜在威胁。为此,使用了多个数据库,如PubMed、MEDLINE、ScienceDirect和爱思唯尔数据库,以搜索相关文章,并按照2020年系统评价和Meta分析的首选项目(PRISMA)指南设定的原则报告结果。设计了特定的医学主题词(MeSH)标准,以在PubMed上搜索相关出版物。经过细致的筛选过程,包括详细的纳入和排除标准、手动阅读标题和摘要以及获取可访问的全文文章,最终共选择了26篇文章。在查阅最初选定论文的参考文献部分后,还选择了一些文章。对选定的出版物进行了质量评估。确定产妇金黄色葡萄球菌定植非常普遍,假设鼻腔定植率高于直肠阴道部位。产妇年龄增加、阴道炎病史和多胎妊娠是最常见的金黄色葡萄球菌定植风险因素。早产儿感染金黄色葡萄球菌的风险最高。母乳也是新生儿耐甲氧西林金黄色葡萄球菌传播的一个风险因素。通过本系统评价,我们得出结论,尽管耐甲氧西林金黄色葡萄球菌的垂直传播率低于甲氧西林敏感金黄色葡萄球菌,但我们认为它具有重要意义,因为感染该病菌的新生儿由于皮肤和软组织感染预后较差,并且耐甲氧西林金黄色葡萄球菌在病房传播给其他新生儿,在三胞胎和四胞胎的情况下传播给兄弟姐妹,甚至可能因潜在的耐甲氧西林金黄色葡萄球菌败血症而死亡。非洲和中国的女性耐甲氧西林金黄色葡萄球菌和金黄色葡萄球菌患病率较高,这可能归因于缺乏足够的医疗设施。我们建议特别是在耐甲氧西林金黄色葡萄球菌负担较高的地区,在确认怀孕后定期进行直肠阴道拭子和鼻拭子筛查,因为预防和筛查对于避免严重并发症是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baf3/9828026/a622e348588d/cureus-0014-00000032366-i01.jpg

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