Malik Sara, Afzal Muhammad Faheem, Hamid Muhammad Haroon
Sara Malik, MD Senior Registrar, University of Child Health and Sciences, Children Hospital, Lahore, Pakistan.
Muhammad Faheem Afzal, FCPS, FCPS (Pediatric Infectious Disease), MHPE Professor Pediatric Medicine, Ameer ud Din Medical College PGMI / Lahore General Hospital, Lahore, Pakistan.
Pak J Med Sci. 2024 Jan-Feb;40(1Part-I):84-88. doi: 10.12669/pjms.40.1.7703.
To compare the risk factors for MRSA colonization in healthy newborns, born of mothers with and without MRSA colonization.
This case control study was conducted in post-natal unit of Lady Willingdon Hospital, affiliated with King Edward Medical University/Mayo Hospital, Lahore from January to June 2017. The vaginal and anterior nares swabs for MRSA culture were collected from mothers within six hours before planned delivery and the neonatal anterior nares swabs for MRSA culture were taken within one hour of birth. All the samples were cultured in Paediatric Microbiology laboratory in Mayo Hospital. Data were analyzed through SPSS 20.0 and logistic regression was applied for risk factors analysis.
Out of total 80 mothers and their newborns, 15 (18.75%) mothers and 16 neonates (20%) were MRSA colonized. The frequency of MRSA colonization in mothers' anterior nares and vaginal swab was 17.5% and 1.25% respectively. The significant risk factors were prolonged rupture of membranes for >18 hours (p-value 0.02, odds ratio 11.85, 95% CI 1.41-99.3), birth weight <2500 grams (p-value 0.01, odds ratio 5.39, 95% CI 1.35-21.4), history of presence of meconium (p-value 0.006, odds ratio 7.30, 95% CI 1.78-29.8). The non-significant factors were age of mother (p-value 0.682, odds ratio 0.765, 95% CI 1.0.212-2.76), parity (p-value 0.185, odds ratio 3.82, 95% CI 0.46-31.66) , gestation (p-value 0.615, odds ratio 0.797, 95% CI 0.714-0.89) , mode of delivery (p-value 0.576, odds ratio 0.543, 95% CI 0.062-4.76), sex of baby (p-value 0.546, odds ratio 0.683, 95% CI 0.196-2.37) and presentation of baby at birth (p-value 0.47, odds ratio 0.795, 95% CI 0.71-0.89).
The presence of meconium, prolonged rupture of membranes and low birth weight were the significant risk factors for MRSA colonization in healthy new-borns, born to mothers with and without MRSA colonization.
比较母亲有无耐甲氧西林金黄色葡萄球菌（MRSA）定植的健康新生儿中MRSA定植的危险因素。
本病例对照研究于2017年1月至6月在拉合尔爱德华国王医科大学/梅奥医院附属的威灵顿夫人医院产后病房进行。在计划分娩前6小时内从母亲处采集阴道和前鼻孔拭子进行MRSA培养，在出生后1小时内采集新生儿前鼻孔拭子进行MRSA培养。所有样本均在梅奥医院儿科微生物实验室培养。通过SPSS 20.0分析数据，并应用逻辑回归进行危险因素分析。
在总共80对母亲及其新生儿中，15名（18.75%）母亲和16名新生儿（20%）被MRSA定植。母亲前鼻孔和阴道拭子中MRSA定植的频率分别为17.5%和1.25%。显著的危险因素为胎膜破裂延长>18小时（p值0.02，比值比11.85，95%可信区间1.41 - 99.3）、出生体重<2500克（p值0.01，比值比5.39，95%可信区间1.35 - 21.4）、胎粪存在史（p值0.006，比值比7.30，95%可信区间1.78 - 29.8）。不显著的因素为母亲年龄（p值0.682，比值比0.765，95%可信区间0.212 - 2.76）、产次（p值0.185，比值比3.82，95%可信区间0.46 - 31.66）、孕周（p值0.615，比值比0.797，95%可信区间0.714 - 0.89）、分娩方式（p值0.576，比值比0.543，95%可信区间0.062 - 4.76）、婴儿性别（p值0.546，比值比0.683，95%可信区间0.196 - 2.37）和出生时婴儿胎位（p值0.47，比值比0.795，95%可信区间0.71 - 0.89）。
胎粪存在、胎膜破裂延长和低出生体重是母亲有无MRSA定植的健康新生儿中MRSA定植的显著危险因素。
