Neonatal outcomes associated with maternal recto-vaginal colonization with extended-spectrum β-lactamase producing Enterobacteriaceae in Nigeria: a prospective, cross-sectional study.

Autor:	Neemann K; Department of Pediatric Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA. Electronic address: kneemann@unmc.edu., Olateju EK; Department of Pediatrics, University of Abuja Teaching Hospital, Gwagwalada, Nigeria., Izevbigie N; International Foundation Against Infectious Diseases in Nigeria (IFAIN), Abuja, Nigeria., Akaba G; Department of Obstetrics and Gynecology, University of Abuja Teaching Hospital, Gwagwalada, Nigeria., Olanipekun GM; International Foundation Against Infectious Diseases in Nigeria (IFAIN), Abuja, Nigeria., Richard JC; International Foundation Against Infectious Diseases in Nigeria (IFAIN), Abuja, Nigeria., Duru CI; International Foundation Against Infectious Diseases in Nigeria (IFAIN), Abuja, Nigeria., Kocmich NJ; Department of Pediatric Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA., Samson KK; Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA., Rezac-Elgohary A; Department of Pediatric Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA., Anigilaje EA; Department of Pediatrics, University of Abuja Teaching Hospital, Gwagwalada, Nigeria., Yunusa T; Department of Medical Microbiology, University of Abuja Teaching Hospital, Gwagwalada, Nigeria., Megafu CON; International Foundation Against Infectious Diseases in Nigeria (IFAIN), Abuja, Nigeria., Ajose TO; International Foundation Against Infectious Diseases in Nigeria (IFAIN), Abuja, Nigeria., Medugu N; International Foundation Against Infectious Diseases in Nigeria (IFAIN), Abuja, Nigeria., Meza J; Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA., Obaro S; Department of Pediatric Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA.
Jazyk:	angličtina
Zdroj:	Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [Clin Microbiol Infect] 2020 Apr; Vol. 26 (4), pp. 463-469. Date of Electronic Publication: 2019 Jul 20.
DOI:	10.1016/j.cmi.2019.07.013
Abstrakt:	Objectives: The objective of this study was to assess the prevalence of maternal recto-vaginal extended-spectrum β-lactamase producing Enterobacteriacea (ESBL-E) colonization, identify risk factors for maternal and neonatal ESBL-E colonization, and subsequent impact on neonatal mortality. Methods: A prospective, cross-sectional study was conducted at the University of Abuja Teaching Hospital from April 2016 to May 2017. Maternal-neonatal pairs were screened for ESBL-E exposure at time of delivery. Neonatal mortality was assessed at 28 days. Results: A total of 1161 singleton deliveries were evaluated. In total, 9.7% (113/1161) of mothers and 4.3% (50/1161) of infants had ESBL-E-positive cultures at delivery. Maternal antibiotic exposure was associated with ESBL-E recto-vaginal colonization (18.6% (21/113) vs. 8.4% (88/1048), p < 0.001)). Maternal ESBL-E colonization (adjusted odds ratio (AOR) 14.85; 95% CI 7.83-28.15) and vaginal delivery (AOR 6.35; 95% CI 2.63-17.1) were identified as a risk factor for positive ESBL-E neonatal surface cultures. Neonatal positive ESBL-E surface cultures were a risk factor for neonatal mortality (stillbirths included, AOR 4.84; 95% CI 1.44-16.31). The finding that maternal ESBL-E recto-vaginal colonization appeared protective in regards to neonatal mortality (AOR 0.22; 95% CI .06-0.75) requires further evaluation. Conclusions: Maternal ESBL-E recto-vaginal colonization is an independent risk factor for neonatal ESBL-E colonization and neonates with positive ESBL-E surface cultures were identified as having increased risk of neonatal mortality. (Copyright © 2019 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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